Cocaine now linked to more deaths than heroin in England and Wales

The number of deaths from cocaine use in England and Wales nearly quadrupled over the past decade and in 2025 cocaine was mentioned in more drug poisoning deaths than heroin or morphine, according to Office for National Statistics data. There were 5,519 drug poisoning deaths registered in 2025, equivalent to 92.4 deaths per million people, and cocaine was mentioned in 1,233 of those cases while heroin or morphine was mentioned in 1,210 cases.

The overall rate of drug deaths fell for the first time since 2012, decreasing from 93.9 deaths per million the previous year, though the ONS noted a lag can exist between deaths occurring and being registered. Despite the small overall decline, experts highlighted widening regional inequalities, with the rate more than twice as high in the North East as in London.

Deaths linked to opiate and opioid drugs combined remained higher than those linked to cocaine alone. Regional increases were steepest in formerly industrial areas with longstanding poverty and unemployment, including the North East, Wales, Yorkshire and the Humber, the North West and the East Midlands.

Ketamine was referenced in a record 115 deaths in 2025, almost double the number from 2024 and up from seven a decade earlier. Commentators attributed the rise to lower prices and the normalization of ketamine use, with reports of young people developing dependence and acute health problems such as bladder damage.

Experts and charity figures warned that increased purity and availability of cocaine and the proliferation of potent synthetic opioids, such as nitazenes, are raising risks for users. Nitazenes can be many times more potent than heroin and have been linked to hundreds of UK deaths. Families affected by recent deaths, including the siblings of Anthony Irvin who died from drug poisoning in Ramsgate in September 2025 at age 52, expressed concern about possible contamination of drug supplies with synthetic opioids and about delays in blood testing.

Liberal News Analysis: What Does This Development Mean?

The data indicate a shifting profile of drug-related harm in England and Wales where cocaine has become a leading named contributor to fatal poisonings, reflecting changes in purity and availability. Although the overall death rate fell slightly, persistent regional disparities and the continuing dominance of opiates and opioids in combined figures show the epidemic remains severe and geographically uneven. The rapid rise in ketamine-linked deaths points to changing patterns of use and emerging health consequences among younger users. Combined with the spread of highly potent synthetic opioids such as nitazenes, these trends complicate response efforts and underscore the need for targeted public health interventions in the worst affected regions.

Quick Glance: What You Need to Know

• There were 5,519 drug poisoning deaths registered in England and Wales in 2025, equivalent to 92.4 deaths per million people.
• Cocaine was mentioned in 1,233 deaths in 2025, slightly fewer than the previous year but more than heroin or morphine which were mentioned in 1,210 deaths.
• The overall drug death rate fell for the first time since 2012, down from 93.9 deaths per million the year before.
• Ketamine-linked deaths reached a record 115 in 2025, nearly double the previous year and markedly higher than a decade ago.
• Regional inequality in drug deaths increased, with the North East having more than twice the rate of London, and rises concentrated in formerly industrial and deprived areas.
• Charities and experts warned that higher cocaine purity and the emergence of potent synthetic opioids such as nitazenes are increasing risks to users.
• Families affected by fatalities reported concerns about contaminated supplies and delays in toxicology results following deaths such as that of Anthony Irvin in Ramsgate.