The number of deaths from cocaine use in England and Wales has nearly quadrupled in a decade, overtaking those attributed to heroin for the first time. Cocaine was linked to more than one in five drug poisoning deaths registered in 2025, more than any other single substance, with charities blaming its increased purity and availability. Meanwhile a record 115 ketamine-linked deaths were registered, almost twice as many as in 2024, according to Office for National Statistics data, external.
The overall rate of drug deaths fell for the first time since 2012. But experts pointed out regional inequality was growing, with the rate of such deaths more than twice as high in the North East as in London. There were 5,519 drug poisoning deaths registered in 2025 in England and Wales, the equivalent of 92.4 deaths per million people.
Of these, cocaine was mentioned in 1,233 cases - slightly fewer than the previous year but higher than the 1,210 deaths linked to heroin or morphine, which also marked a fall from the previous year's level. However, deaths linked to opiate and opioid drugs combined were still higher. The ONS also said there was a lag between deaths occurring and being registered.
The fatality rate fell from 93.9 deaths per million people a year earlier, representing the first annual decline since 2012. In September, National Records of Scotland said drug deaths there had risen by 11% in 2025 on the year before, marking the worst mortality rate in Europe, In May the Northern Ireland Statistics and Research Agency said drug-related deaths rose by 7.1% between 2021-23 and 2022-24, external. Dr James Morgan, who specialises in addiction and mental health at London Metropolitan University, said while there had been a slight decrease in deaths "the numbers remain objectively high", with total drug fatalities in England and Wales roughly doubling since 2012.
"What we are seeing is increasing polarisation and growing inequalities, where the poorest regions are falling behind, and more affluent regions doing better," he said. The steepest increases were found in formerly industrial areas with high levels of poverty and unemployment dating back to the 1980s, including the North East, Wales, Yorkshire and the Humber, the North West and the East Midlands. Morgan pointed out that cocaine death figures included not only those who snorted the drug but also users who injected it or smoke 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," he said. Meanwhile, ketamine was referenced in 115 deaths last year - almost double the year before and up from just seven fatalities 10 years earlier.
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