Cocaine has overtaken heroin as the biggest cause of drug deaths in England and Wales, according to new figures from the Office for National Statistics, with 1,233 deaths attributed to the drug last year. Charities have responded by saying the government "must act now to reverse this deadly trend".
Although the overall number of drug deaths dipped slightly in 2025 compared with the previous year, the figures remained historically high at double the rates recorded a decade ago. Deaths specifically linked to cocaine are now four times higher than they were 10 years ago, and eight times higher than in 2010.
The data marks the first time cocaine has been the drug most involved in drug-related deaths, accounting for 22% of the total. That figure includes powder cocaine use as well as deaths caused by injecting the drug or smoking it in the form of crack cocaine. Almost two thirds of registered cocaine deaths, 64%, involved people over the age of 40, a pattern also reflected among those seeking help from drug treatment services.
In total, 5,519 deaths related to drug poisoning were registered last year, 46 fewer than in 2024. The north-east of England recorded the highest rate at 135.2 deaths per million people, while London had the lowest at 58.3 per million. Deaths were five times higher in the most deprived areas than in the least deprived.
The figures also show a sharp rise in deaths involving ketamine, albeit from a very low base a decade ago. Ketamine was mentioned in 115 deaths in 2025, compared with 27 in 2020 and just seven in 2015.
Niamh Eastwood, executive director of Release, the UK's national centre of expertise on drugs and drug laws, said cocaine deaths were "a direct result of policy failures both in the UK and internationally". She said: "Cocaine production is at an all-time high; it's more available, cheaper and purer than ever, despite billions spent on trying to disrupt or eradicate the trade." The NGO argued that the UK's emphasis on punishing drug use has blocked harm-reduction interventions, leaving people who use cocaine with "literally nothing practical on offer".
Mike Trace, chief executive of the social justice charity Forward Trust, called the overall drug-related death rate "a national scandal" requiring urgent attention. "We're facing the perfect storm of record levels of production in South America leading to falling prices combined with increasing purity, which means increasing potency and risk," he said.
Will Haydock, chief executive of the drug treatment campaigning charity Collective Voice, warned that earlier progress is "now at risk due to government inaction". He said the government had been largely silent on addiction for more than two years and had paused the planned investment programme, freezing funding at year-three levels rather than following the path set out by the independent review of drugs. That review, led by Prof Carol Black, was commissioned under Boris Johnson's government and published in 2021, recommending an overhaul of drug treatment services.
Haydock said a new drugs strategy with clear priorities, including reducing drug-related deaths, was urgently needed. "If we get our response to alcohol and other drugs right, we can save and improve hundreds of thousands of lives," he said.
