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

Cocaine has replaced heroin as the primary driver of drug-related mortality in England and Wales. The Office for National Statistics reported that 1,233 deaths were attributed to cocaine in 2025. This figure represents 22% of all drug deaths and marks the first time the substance has held the top position. The count includes powder cocaine, injected cocaine, and crack cocaine.

Total drug poisoning deaths numbered 5,519 in 2025, a decline of 46 cases from the previous year. Despite this slight drop, the rate remains historically high, sitting at double the level recorded ten years ago. Cocaine-specific deaths have quadrupled since 2015 and increased eightfold since 2010. Ketamine also saw a sharp rise, appearing in 115 deaths in 2025 compared to 27 in 2020 and seven in 2015.

Geographic disparities remain stark. The north-east of England recorded the highest rate at 135.2 deaths per million people. London recorded the lowest rate at 58.3 per million. Deaths in the most deprived areas were five times more frequent than in the least deprived areas. Age demographics show that 64% of registered cocaine deaths involved individuals over the age of 40. This pattern mirrors trends seen among those seeking help from drug treatment services.

Charities have criticized the government's response to the rising toll. Niamh Eastwood, executive director of Release, described the increase as a direct result of policy failures. She noted that cocaine production is at an all-time high, making the drug more available, cheaper, and purer. Eastwood argued that the UK's focus on punishment has blocked harm-reduction interventions, leaving users with "literally nothing practical on offer."

Mike Trace, chief executive of Forward Trust, labeled the overall death rate a national scandal. He cited a combination of record production in South America, falling prices, and increasing purity as the core issues. Will Haydock, chief executive of Collective Voice, warned that earlier progress is now at risk due to government inaction. He stated that the government had been largely silent on addiction for more than two years.

Haydock pointed to a freeze in funding at year-three levels, diverging from the path set out in the 2021 independent review of drugs. That review, led by Professor Carol Black, recommended an overhaul of drug treatment services. He called for a new drugs strategy with clear priorities to reduce drug-related deaths. Haydock said that getting the response to alcohol and other drugs right could save and improve hundreds of thousands of lives.