Cocaine overtook heroin and morphine as the leading single substance linked to drug poisoning deaths registered in England and Wales in 2025, according to Office for National Statistics data. The number of deaths associated with cocaine has nearly quadrupled in a decade.
There were 5,519 drug poisoning deaths registered during the year, equivalent to 92.4 deaths per million people. Cocaine was mentioned in 1,233 cases, slightly fewer than the previous year but more than the 1,210 deaths linked to heroin or morphine. Deaths involving opiates and opioids combined remained higher. The ONS cautioned that there is a delay between deaths occurring and being registered.
The overall rate fell from 93.9 deaths per million in the previous year, marking its first annual decline since 2012. However, experts highlighted a widening regional gap: the rate in the North East was more than twice that in London. The steepest increases were reported in areas including the North East, Wales, Yorkshire and the Humber, the North West and the East Midlands.
Dr James Morgan, an addiction and mental health specialist at London Metropolitan University, said the modest fall should not obscure the scale of the problem. He said total drug fatalities had roughly doubled since 2012, and cocaine-related deaths remained about four times their 2015 level. He also noted that cocaine figures include people who inject the drug or smoke crack, sometimes alongside opioids or counterfeit medicines.
Ketamine was mentioned in 115 deaths in 2025, almost twice the 2024 figure and up from seven deaths a decade earlier. Morgan attributed the increase to lower prices and more normalised use, and pointed to reports of young people developing dependence and serious health problems, including bladder damage.
Mike Trace, chief executive of addiction charity Forward Trust, said deaths remained high amid factors including the spread of potent synthetic opioids known as nitazenes and rising cocaine purity. Nitazenes can be many times stronger than heroin and have been linked to hundreds of deaths in the UK.
Sources: BBC News UK.