Cocaine has become the most frequently mentioned single substance in drug poisoning deaths across England and Wales for the first time, surpassing heroin as the primary driver of drug fatalities. According to BBC News, cocaine was linked to more than one in five drug poisoning deaths registered in 2025, with charities attributing the rise to increased purity and availability of the drug.
The number of deaths involving cocaine has nearly quadrupled over the past decade, rising from 144 cases in 2010 to 1,233 in 2025—more than an eightfold increase according to Office for National Statistics data. This represents a slight decrease from the previous year's 1,210 deaths linked to heroin or morphine, though combined opiate and opioid deaths remain higher than cocaine alone.
A total of 5,519 drug poisoning deaths were registered in 2025 in England and Wales, equivalent to 92.4 deaths per million people. This marked the first annual decline in the overall drug death rate since 2012, falling from 93.9 deaths per million the previous year. However, the ONS cautions that only 37.3% of drug-poisoning deaths registered in 2025 actually occurred that year, reflecting significant delays in the registration process.
Regional disparities widening
Despite the overall decline, experts highlighted growing regional inequality in drug death rates. The North East experienced the highest mortality rate, though the region's rate fell from 167.6 to 135.2 deaths per million in 2025, the largest decrease among English regions, while London remained lowest at 58.3. The steepest increases overall were concentrated in formerly industrial areas with high levels of poverty and unemployment dating back to the 1980s, including Wales, Yorkshire and the Humber, the North West, and the East Midlands.
Dr James Morgan, who specialises in addiction and mental health at London Metropolitan University, described the situation as one of increasing polarisation.
What we are seeing is increasing polarisation and growing inequalities, where the poorest regions are falling behind, and more affluent regions doing better.He noted that while there had been a slight decrease in overall deaths, the figures remained objectively high, with total drug fatalities in England and Wales roughly doubling since 2012.
Gender disparities in mortality
Analysis of mortality patterns revealed significant differences between men and women. The male drug-poisoning mortality rate rose to 130.0 per million in 2025, while the female rate fell to 56.6 per million, widening the gap between the sexes. This disparity reflects broader patterns in drug use and access to treatment services across the country.
Why has cocaine become more deadly?
The surge in cocaine-related fatalities stems from multiple factors. Charities and experts point to the drug's increased purity and availability as primary drivers. Morgan explained that cocaine death figures encompassed not only those who snorted the drug but also users who injected it or smoked crack cocaine in combination with opioids or counterfeit pharmaceutical drugs.
The small decline in deaths related to cocaine should not be over-interpreted. Most important is that deaths relating to cocaine remain roughly quadruple what they were in 2015 and are now more frequent than deaths relating to heroin or morphine.
Mike Trace, CEO of the addiction charity Forward Trust, highlighted the role of increasingly potent synthetic drugs.
We know that increasingly potent drugs like nitazenes are making their way on to the market. We know that established drugs like cocaine are growing in purity which means they come with much higher risks to users.Nitazenes, synthetic opioids many times more potent than heroin, have been linked to hundreds of UK deaths and are frequently mixed with other substances.
Ketamine deaths nearly double
A record 115 ketamine-linked deaths were registered in 2025, almost double the 59 deaths recorded in 2024 and a dramatic rise from just seven fatalities a decade earlier. Morgan attributed this increase to lower prices and the normalisation of ketamine use, particularly among young people.
There were increasing reports of young people becoming dependent on ketamine and suffering acute health difficulties such as bladder damage.
Data limitations and registration delays
The ONS acknowledged significant limitations in its data collection. The statistics office lacks access to post-mortem reports and toxicology results, meaning incomplete information on death certificates may result in some drug-related deaths or substances not being captured in the figures. The substantial lag between when deaths occur and when they are registered—with only about one-third of 2025 deaths registered that same year—further complicates the picture of current drug mortality trends.
Personal impact of the crisis
The statistics represent individual tragedies affecting families across the country. Tom Powell and Nyk Irvin's brother Anthony Irvin died from drug poisoning in Ramsgate in September 2025 at the age of 52. His siblings believe his death resulted from a contaminated drug supply containing synthetic opioids, but say delays in blood testing mean they will never know with certainty.
Today's figures are shocking. We are fighting to wake people up to the scale of the problem.
Broader context across the UK
The situation in England and Wales reflects wider drug mortality challenges across the UK. Scotland's drug-related deaths rose 11% to 1,133 in 2025, maintaining Europe's worst fatality rate, while Northern Ireland saw drug-related deaths rise by 7.1% between 2021-23 and 2022-24. These figures underscore the scale of the drug poisoning crisis affecting multiple nations within the United Kingdom.
Key Facts
- Cocaine was mentioned in 1,233 drug poisoning deaths in 2025, surpassing heroin or morphine (1,210 deaths) for the first time
- Cocaine-related deaths have increased more than eightfold since 2010, rising from 144 to 1,233 cases
- Ketamine-linked deaths nearly doubled year-on-year, reaching 115 in 2025 compared with 59 in 2024
- The overall drug death rate fell for the first time since 2012, though regional disparities remain stark, with the North East's rate more than double London's
- Only 37.3% of drug-poisoning deaths registered in 2025 actually occurred that year, reflecting significant delays in the registration process
