Cocaine Overtakes Heroin as Leading Cause of Drug Deaths in England and Wales

The number of deaths linked to cocaine use in England and Wales has nearly quadrupled over the past decade, surpassing those attributed to heroin for the first time. In 2025, cocaine was cited in more than one in five drug poisoning fatalities, making it the most frequently mentioned single substance, according to Office for National Statistics (ONS) data. While 1,233 deaths mentioned cocaine, a slight decrease from the previous year, this figure exceeded the 1,210 deaths linked to heroin or morphine. This shift marks a significant trend in drug-related mortality, with charities pointing to increased purity and availability of cocaine as contributing factors.

Alongside the rise in cocaine-related deaths, ketamine was referenced in a record 115 fatalities in 2025, almost doubling the figure from 2024 and a substantial increase from just seven deaths a decade prior. Dr James Morgan, an addiction and mental health specialist at London Metropolitan University, attributed this rise to lower prices and the normalization of ketamine use, noting increasing reports of young people developing dependence and suffering acute health issues like bladder damage. Despite these specific increases, the overall rate of drug deaths in England and Wales saw its first annual decline since 2012, falling from 93.9 deaths per million people to 92.4 deaths per million, with a total of 5,519 drug poisoning deaths registered in 2025.

However, Dr Morgan cautioned against over-interpreting the slight decrease in overall deaths, stating that numbers "remain objectively high," with total drug fatalities roughly doubling since 2012. He highlighted growing regional inequality, where the death rate is more than twice as high in the North East compared to London. Steepest increases were observed in formerly industrial areas such as the North East, Wales, Yorkshire and the Humber, the North West, and the East Midlands, regions characterized by high levels of poverty and unemployment dating back to the 1980s. Mike Trace, CEO of the addiction charity Forward Trust, also noted the proliferation of potent synthetic opioid drugs like nitazenes, which are many times stronger than heroin and have been linked to hundreds of UK deaths, further exacerbating the risks posed by increasingly pure established drugs like cocaine.

The human impact of these statistics is profound. Anthony Irvin, 52, died from drug poisoning in Ramsgate in September 2025. His siblings, Tom Powell and Nyk Irvin, believe his death was caused by drugs contaminated with synthetic opioids, though delays in blood testing mean definitive answers may never be known. Powell described the figures as "shocking," emphasizing the ongoing struggle to raise awareness about the scale of the problem. While opiate and opioid drugs combined still account for a higher number of deaths overall, the ONS noted a lag between deaths occurring and their registration.

Editor's note: Faithfully reports ONS drug death statistics, expert analysis, and case study details.