The state government inquiry into end-of-life choices was told that 52 Victorians died using pentobarbitone, otherwise known as nembutal or "the peaceful pill", between 1999 and 2014.

Coroners Prevention Unit manager Jeremy Dwyer told the Legal and Social Issues Committee that the majority of those suicides were young people who were physically healthy, but mentally ill.

"There have been claims from the authors of The Peaceful Pill Handbook that their messages are only intended for one group [the elderly and seriously ill]," he said.

"But the unintended consequences of it is that people who are not the stated audience are picking up on it, they're obtaining Pentobarbitone in the way recommended in the The Peaceful Pill Handbook and Exit International material and they're suiciding.

"That group used to be the minority, now it's the majority of Pentobarbitone suicides in Victoria."

It is understood pentobarbitone is being shipped in from overseas.

While there is concern about young people using the drug, many more Victorians are battling crippling and incurable illnesses and taking their lives each year, often dying alone and in harrowing circumstances.

The inquiry heard that there were 197 suicides in Victoria between 2009 and 2014 in which which the deceased was suffering from an "irreversible deterioration of their physical health".

This includes people who were living with cancer, incurable conditions such as multiple sclerosis and chronic pain-related disorders resistant to medication.

Coroner John Olle went through five suicide cases in distressing detail during the Wednesday evening hearing.

He described an 82-year-old woman who had been suffering from multiple illnesses before she lost her vision and could no longer read books, a hobby she described as "the most important part of her life".

She would later take her life in violent circumstances.

The hearing was told it was common for a person who  suicides to have expressed a willingness to die to their families because of their physical suffering or quality of life.

"There's a cry for help they can't answer," Mr Olle said.

"It may be muted, it may be veiled, but it's there nonetheless and they all know it. Even the doctors."

Dr Dwyer said people often lived with multiple and deteriorating health problems for many years before suicide.

"Conditions are significant to different people in different ways," Dr Dwyer said. "You could have people that live with diabetes and hypertension for years and then their eyesight goes and their licence gets taken away and they realise things are never going to get better."

Victoria Police Acting Crime Commander Rod Wilson said it was the job of police to enforce the current laws on assisted suicide.

"At present individuals, including doctors, are at risk of prosecution if they intentionally take the life of any person suffering an irreversible deterioration of physical health – that is the common law of murder," he said.

However, prosecutions are few and far between. Mr Wilson said there were only five reported cases of aid and abet suicide between 2010 and 2014 and in his entire career in the homicide squad he had only charged one person with the crime.

For help or information contact: Lifeline 131 114, beyondblue 1300 224 636, SuicideLine 1300 651 251.