Cocaine-linked deaths overtake heroin in England and Wales

Cocaine was mentioned in more drug-poisoning deaths registered in England and Wales in 2025 than any other single substance, according to figures from the Office for National Statistics. Both cocaine-linked and heroin-or-morphine-linked registrations fell from the previous year.

Deaths linked to opiates and opioids combined still outnumbered those linked to cocaine. The ketamine figure was almost twice the previous year’s level; a decade earlier, 7 deaths involved the drug.

There were 5,519 drug-poisoning deaths registered in total, the BBC said. The statistics office said a delay between death and registration means a death registered in 2025 did not necessarily occur that year.

The overall drug-poisoning mortality rate fell from 93.9 per million people in 2024 to 92.4 per million in 2025, its first annual decline since 2012.

Experts warn about drug potency

Dr James Morgan, an addiction and mental-health specialist at London Metropolitan University, cautioned against overinterpreting the small decline in cocaine-linked deaths. He said the figure remained roughly four times its 2015 level. Cocaine figures include people who snorted it as well as those who injected it or smoked crack cocaine alongside opioids or counterfeit pharmaceutical drugs, he said.

Morgan attributed the rise in ketamine deaths to lower prices and increasingly common use. He said reports were growing of young people developing dependence and serious health problems, including bladder damage.

Mike Trace, chief executive of addiction charity Forward Trust, said increasingly potent synthetic opioids called nitazenes were entering the market and that rising cocaine purity brought greater risks to users.

The drug-death rate in the North East was more than twice London’s. Morgan said regional inequalities were growing, with poorer regions falling behind more affluent ones.

Anthony Irvin died from drug poisoning in Ramsgate in September 2025, aged 52. His siblings, Tom Powell and Nyk Irvin, believe synthetic opioids contaminated his drug supply, but say delays in blood testing mean they will never know for sure.