Twenty people have died from suspected opioid overdoses this year, more than double the number of deaths recorded in 2023, when nine people died under similar circumstances.
Police say the most recent death, a young man, was reported on Wednesday.
The alarming increase in fatal overdoses comes as local pill-testing service CanTEST reports a spike in people wanting their drugs checked.
ACT Policing's Acting Commander Operations Rich Breiner said the exact causes of the overdoses, likely resulting from non-prescription drugs, were yet to be determined by the coroner.
However, police suspected high drug purity levels or the presence of synthetic opioids like fentanyl or nitazenes in commonly used drugs.
"ACT Policing has conducted search warrant activity on known illicit drug dealers and will continue to target people who seek to profit from the sale of these illegal substances," the acting commander said.
He said police were investigating sources but it was unclear if the drugs could be traced back to one dealer or network.
"Police are also aware of some users sourcing their drugs through online marketplaces on the dark web," he said.
Acting Commander Breiner said police encouraged people to test drug samples at CanTEST, located at 1 Moore Street in the city.
CanTEST's clinical lead, David Caldicott, said the free service - available on Thursdays and Fridays - provides drug analyses within minutes unlike the police's forensic process.
The toxicology expert and emergency doctor said this was because pill samples were the finished product brought in by consumers, while it could take a month to detect synthetic opioids in big batches of drugs seized by police.
Drug checking 'saves lives'
In 2022, there were 2356 drug-induced deaths in Australia, exceeding the number of road-related deaths that year, the Pennington Institute's 2024 overdose report showed.
Its research also showed opioids contributed almost 50 per cent of unintentional drug-induced deaths that year. The institute's chief executive, John Ryan, said drug checking was a simple way to save lives.
Dr Caldicott said CanTEST was finding nitazenes (100 times stronger than heroin) in commonly used drugs like meth, cocaine, and ecstasy.
"There has been an explosion of nitazenes in opioids," he said.
"People don't buy cocaine for the purposes of being sent to sleep. When you are expecting an effect of a drug and something completely different happens, that's when tragedies occur," the doctor said.
He said nitazenes also masqueraded as pharmaceutical drugs that were increasingly "stolen" for recreation in Australia.
CanTEST had tested pills that looked like oxycodone but contained nitazenes, Dr Caldicott said.
Dr Caldicott said countries trialling MDMA to treat traumatised patients used 75-110mg of the drug, whereas he had seen batches containing almost three times the quantity.
"[High-potency MDMA] can result in problems with heart rate, temperature regulation, and a condition known as serotonin syndrome, from which people have definitely died," he said.
Young people becoming more concerned
Contrary to "conservative commentators", Dr Caldicott said younger generations had a lot of concerns about their health because there had been a spike in demand for pill-testing.
"We see more and more people presenting [at CanTEST]," he said. "We could definitely increase [the days of] service and still not meet the demand for testing."
Program manager Steph Tzanetis said for the first time the service analysed more than 200 samples in a month, between September 21 and October 20.
Dr Caldicott said more young people wanted to use their service as more dangerous drugs entered the market.
About 40 people turned up at CanTEST in one evening when concerns circulated about specific drugs. Up to 300 people would get samples checked a day at festivals.
"They know that they can get reliable, non-judgmental information about what the findings of the pills [are]," he said.
"There is pretty much insatiable demand ... and it's not just to have their drugs checked, it's also to have a conversation with somebody who knows about drugs."
Drug behaviour since decriminalisation
When the ACT decriminalised the possession of small quantities of nine common illegal substances in October 2023, some groups had concerns about Canberra becoming a hotpot for drug tourism.
Almost 12 months since the drug reforms, this is what police say.
Between October 28, 2023, and October 15 this year, 237 people found carrying these drugs opted to attend an education session with Canberra Health Services staff.
About 17 per cent (42 people) had not yet attended the course.
In the same period, police issued 13 fines to people who did not choose diversion or had been charged with other offences.
Can the 100 per cent increase in fatal overdoses this year be linked to drug decriminalisation? "I think that's nonsense," Dr Caldicott said.
He said increased mortality associated with drugs was "almost certainly a consequence" of the nature and changes in the drug market.
"[The ACT is] in a far better position to identify and act on changes in the drug market early, which have a public health implication, than jurisdictions that don't have decriminalisation."
Acting Commander Rich Breiner said police believe drug addiction was a health issue, not a criminal issue.
ACT Policing's Detective acting Superintendent Dave Craft had previously told journalists there was "no correlation" between increasing fatal overdoses at the time and decriminalisation.
He also said police officers' first aid kits would include naloxone, a drug to treat someone experiencing an opioid overdose, in the future.
Naloxone is available in local pharmacies for free as part of the ACT's Take Home Naxolone initiative.
