A further three overdose deaths at music festivals fuelled calls and protests for pill testing.
At the hearing, senior counsel assisting, Sally Dowling, said the most common ATS was MDMA and the purest form was ice, which gave users the most intense high as well as the most intense comedown.
«It has the highest potential for dependence and chronic physical and mental problems,» she said.
«Between 2013 and 2016 the proportion of injecting crystal methamphetamine users in Australia doubled from 9.4 per cent to 19.2 per cent.»
Ms Dowling said preliminary submissions showed ice was «very prevalent» and caused «significant» harm to users and their families.
She said the driving factors were «complex» and rooted in social disadvantage.
The inquiry will focus on specific groups, including those in rural and regional areas where services are limited, and Indigenous people, who are using illicit drugs at twice the rate of non-Indigenous Australians.
«The impacts of ATS use on Indigenous communities are compounded by other factors including poorer health and higher incarceration levels,» Ms Dowling said.
A First Nations Advisory Committee has been created to boost engagement with the Indigenous community.
In recognition that ice is hitting regional areas harder, hearings will be held in Lismore, Nowra, Dubbo, East Maitland and Broken Hill.
The inquiry will also focus on people who are LGBTQI, incarcerated, in particular industries, such as «fly-in, fly-out» workers, and in ethnic groups.
It will hear from families of users and first responders such as police and paramedics.
«You will hear evidence that methamphetamine presentations to emergency departments and hospitalisations associated with methamphetamine use have increased almost tenfold in NSW since 2009,» Ms Dowling said.
The inquiry will also scrutinise the government’s implementation of the existing National Drug Strategy and the National Ice Action Strategy.
It will take into account the inquest into the five drug-related deaths at music festivals over the summer, which will be held in July.
Its high-powered expert advisory panel includes former police commissioner Andrew Scipione and Former NSW Director of Public Prosecutions Nicholas Cowdery.
The public are being encouraged to lodge their submission by May 7. The commission will deliver its report to the governor on October 28 this year.
Esther Han is the state politics and health reporter at The Sydney Morning Herald