Abstract Objective : The paper highlights the extent of pharmaceutical drug misuse problems in Australia and explores how pharmaceutical opioid misuse could be reduced by implementation of a technological tool: a prescription co‐ordination program (PCP). The paper explores how enhancements to existing computer‐assisted clinical decision support systems through real‐time, on‐line information to prescribers, pharmacists and regulators could address drug‐seeking and improve the quality use of medicines. Approach : Trends in national and international prescription opioid use and related harms are examined with attention directed to drug‐seeking behaviour and intentional misuse. The international literature concerning PCPs is reviewed and implications for technological advances in Australia are outlined. Conclusion : Australia has a burgeoning problem associated with the misuse of pharmaceutical opioids. There is increased recognition of a range of iatrogenic harms. A number of factors limit Australia's response capacity including lack of technological capacity to provide on‐line, real‐time information for prescribers and pharmacists. Implications : Providing prescribers, pharmacists and regulators with on‐line, real‐time information about patients’ prescription opioid use will improve the quality use of medicines. A national system is required to co‐ordinate data on Pharmaceutical Benefits Scheme, Repatriation Pharmaceutical Benefits Scheme and unsubsidised medicines, including private prescriptions. Pharmaceutical opioids are not the only medicines subject to misuse and therefore the need to capture data on other relevant medicines is also addressed.