Cocaine tops drug death list in England and Wales

Cocaine is now the leading cause of drug-related deaths in England and Wales, according to data released by the Office for National Statistics. The agency reported 1,233 deaths attributed to the drug in the most recent year, marking the first time it has overtaken heroin in this category. This substance accounted for 22% of all registered drug poisoning deaths.

The total number of drug deaths stood at 5,519, which is 46 fewer than the previous year. Despite this slight decline, the figures remain historically high, sitting at double the rates recorded ten years ago. Cocaine-specific deaths have quadrupled over the last decade and are eight times higher than in 2010. The data covers powder cocaine, injected use, and crack cocaine.

Geographic and socioeconomic patterns are distinct in the new figures. The north-east of England recorded the highest rate at 135.2 deaths per million people, while London had the lowest at 58.3 per million. Deaths in the most deprived areas were five times higher than in the least deprived areas. Age demographics also shifted, with 64% of registered cocaine deaths involving individuals over the age of 40. This aligns with trends seen in people seeking help from drug treatment services.

Charities and experts are calling for immediate policy changes. Niamh Eastwood, executive director of Release, described the rise as a direct result of policy failures both in the UK and internationally. She noted that cocaine production is at an all-time high, making the drug more available, cheaper, and purer despite billions spent on disrupting the trade. Her organization argued that the UK's focus on punishing drug use has blocked practical harm-reduction interventions.

Mike Trace, chief executive of Forward Trust, called the overall death rate a national scandal. He cited a combination of record production levels in South America and increasing purity, which leads to greater potency and risk. Will Haydock, chief executive of Collective Voice, warned that earlier progress is now at risk due to government inaction. He stated that the government has been largely silent on addiction for more than two years and paused the planned investment program, freezing funding at year-three levels instead of following the 2021 independent review led by Prof Carol Black.

Haydock urged the government to create a new drugs strategy with clear priorities to reduce deaths. He said that getting the response to alcohol and other drugs right could save and improve hundreds of thousands of lives. The ONS data also highlighted a sharp rise in deaths involving ketamine, which was mentioned in 115 deaths in 2025, compared to 27 in 2020 and seven in 2015.