Wagga's fatal drug overdoses have increased by 50 per cent over the past few years, with rural isolation, underlying social problems and users mixing different substances blamed for the rising deaths.
Calvary Riverina Drug and Alcohol Services manager Brendan McCorry said the figures were "a tragedy" and "not very encouraging".
"It highlights that something needs to be done to address the issue of people unintentionally overdosing," he said.
"It's a combination of both legal and illicit drugs that are contributing to people accidentally overdosing. There's just as much prescription drugs as illicit drugs involved.
"The [overdose figures] report does say that drugs like amphetamines, which we all know are increasing in use, are now more widely used as one of up to seven different drugs used at one time in a person's drug taking that has led to an overdose."
The area including Wagga, Junee, Coolamon, Ganmain, Temora, Gundagai, Cootamundra, Lockhart and The Rock saw 30 unintentional fatal drug overdoses between 2014 and 2018.
A decade ago, the figure was just 20 deaths over four years.
Mr McCorry said mixing alcohol with prescription opiate painkillers or anti-anxiety tranquilizers like benzodiazepine "seem to contribute to overdoses".
"It can have a more toxic outcome, and it can be hard to predict tolerances to different drugs or how they will increase in potency when interacting with other drugs," he said.
Albury and its surrounding region saw a 47 per cent increase during the same time period for 2014 to 2018 for a total of 25 deaths.
Tumut and Tumbarumba's overdose numbers remained low but shot up by 400 per cent from one incident every few years to five incidents in the same time frame.
Mr McCorry said social and mental health issues and greater physical isolation in rural areas could be contributing to the increase outside of regional cities.
"If they are on their own [during an overdose], there is noone to get help for them or it's often some distance to get to medical help," he said.
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The figures were contained in the latest Australia's Annual Overdose Report from the Melbourne-based Penington Institute, a health research agency that promotes drug harm minimisation.
"In the five years between 2014 and 2018, there were 30 unintentional overdose deaths in Wagga Wagga. That's an unacceptably high number - and it's 30 too many," Penington Institute chief executive John Ryan said.
"The data is clear: the overdose situation in Wagga Wagga is not improving and in fact appears to be deteriorating. People are suffering and dying unnecessarily and all levels of government and society are not doing enough to keep them safe.
"This is Australia's hidden health crisis. By releasing this Report with the most up-to-date data, we're looking to start a conversation, bring overdose out of the shadows and ultimately reduce harms."
Mr McCorry said increased drug education and awareness was a starting point for reducing overdoses, along with support services for at-risk people who were using drugs and prescription monitoring to prevent abuse.
"We could also address the issues that lead to people taking these drugs in the first place," he said.