Cocaine overtakes heroin as the leading cause of drug deaths in England and Wales for the first time

Cocaine overtakes heroin as the leading cause of drug deaths for the first time

In England and Wales, 5,519 deaths from drug poisoning were registered in 2025 — 92.4 cases per million people. Cocaine was mentioned in 1,233 cases, heroin or morphine in 1,210; thus, cocaine became the most frequently mentioned individual substance in drug poisoning deaths for the first time, BBC News reports, citing data from the Office for National Statistics (ONS). Over the decade, the number of cocaine-related deaths has grown almost fourfold, although it slightly declined compared with the previous year. Overall, deaths involving opiates and opioids remain higher, and the ONS notes a lag between the moment of death and its registration.

The overall rate has fallen, but inequality is growing

The overall mortality rate fell from 93.9 to 92.4 per million — the first annual decline since 2012. At the same time, as James Morgan, a specialist in addictions and mental health at London Metropolitan University, noted, the figures remain 'objectively high': the total number of drug deaths in England and Wales has roughly doubled since 2012. The largest increase is seen in former industrial regions with high poverty and unemployment — the North East, Wales, Yorkshire and the Humber, the North West and the East Midlands; the mortality rate in the North East is more than twice as high as in London. 'We are seeing growing polarisation: the poorest regions are falling behind, while more affluent ones are coping better,' Morgan said. He warned against overestimating the small decline in cocaine deaths: they remain roughly four times higher than the 2015 level.

Ketamine and synthetic opioids

A separate worrying trend is ketamine: in 2025 it was mentioned in 115 deaths — almost twice as many as a year earlier, compared with seven cases ten years ago. In Morgan's view, this is linked to falling prices and the normalisation of use; he noted a growing number of reports of addiction among young people and acute health problems, including bladder damage. Mike Trace, head of the charity Forward Trust, links the persistently high level of poisoning deaths in part to the spread of nitazenes — very potent synthetic opioids that can be many times stronger than heroin and have already been linked to hundreds of deaths in the UK — as well as to rising cocaine purity, which increases risks for users. In Scotland, according to National Records of Scotland, drug deaths rose by 11% in 2025 — the worst mortality rate in Europe; in Northern Ireland, according to NISRA, the increase from 2021–23 to 2022–24 was 7.1%.

A personal story behind the statistics

One of the cases behind the statistics is the death of 52-year-old Anthony Irvin in Ramsgate in September 2025. His brother Tom Powell and sister Nyk Irvin believe the cause was a batch of drugs contaminated with synthetic opioids, but, according to them, delays in blood tests mean they will never know for certain. 'Today's figures are shocking. We are fighting to make people realise the scale of the problem,' Powell said.

Image source, Getty Images

Image source, Family handout