Cocaine deaths reach a record in England and Wales
An experimental estimate suggests consumption rose without more people reporting use, while the number starting treatment in England increased.
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An experimental estimate suggests consumption rose without more people reporting use, while the number starting treatment in England increased.
Cocaine-related deaths have reached a record in England and Wales. Older people account for most of the increase, and more than half of the deaths registered in 2025 involved someone over 40.
Yet crime survey figures suggest the number of people reporting cocaine use in the previous year has stayed flat or fallen slightly since the pandemic. The Guardian’s October 25 analysis brings together consumption estimates, treatment figures and mortality patterns to explain how that can happen: the amount consumed can rise without an increase in the number of users.
In June 2026, Home Office scientists published an experimental estimate based on sewage samples. It suggested cocaine consumption rose 26% between 2021 and 2025, with an estimated 123,000kg consumed in England in 2024–25. Sewage-based estimates have substantial margins of error.
The measures answer different questions. A survey counts people who say they used cocaine during the past year; the sewage estimate concerns the amount consumed. One possible explanation is that a similar or smaller group is using cocaine more frequently.
The survey also excludes people who are homeless or living in institutions, and some respondents may be reluctant to disclose illegal drug use. Drug-market specialist Dr Josh Torrance says wastewater analysis can reveal use that surveys miss.
In England, 33,612 people started treatment for cocaine problems in 2024–25, up 57% from 2019–20. The Guardian interprets that increase as another indication that frequent use may be growing.
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Despite its limitations, the survey still identifies younger people as the most likely to use cocaine. But it indicates falling use among younger people and rising use among older groups. People in their 30s were the largest age group seeking help, compared with people in their 20s ten years earlier.
We’ve seen a cohort of cocaine users age and continue to use cocaine
Analysis
The National Crime Agency says wholesale cocaine purity—the proportion that is cocaine rather than other substances—has remained high in recent years. High purity, ageing users and a possible increase in frequent use have coincided with mounting harm; these trends do not establish how much each factor contributed to the rise in deaths.
Torrance says acute overdose deaths often involve heart problems, while the health effects of long-term cocaine use add to the risks.
An independent report in 2025 found that the UK lacked a coordinated drug prevention strategy with dedicated funding. Torrance argues that earlier drug education and helping people at risk engage with services would reduce problems later in life.
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