By Karim Hammam
Cocaine has overtaken heroin as the leading cause of drug-related deaths in England and Wales, according to latest figures from the Office for National Statistics. Charities warn the government must act urgently to reverse the trend, with 1,233 cocaine-specific deaths recorded last year.
Deaths at historically high levels
Overall drug poisoning deaths fell slightly to 5,519 in 2025, down 46 from the previous year, but remain double the rate of a decade ago. Cocaine-specific deaths are now four times higher than ten years ago and eight times higher than in 2010, accounting for 22% of all drug-related deaths.
Demographic and regional disparities
Nearly two-thirds of cocaine deaths involved people over 40, a trend mirrored in drug treatment services. The north-east of England recorded the highest death rate at 135.2 per million people, while London had the lowest at 58.3 per million. Deaths were five times higher in the most deprived areas compared to the least deprived.
Rising ketamine deaths
Ketamine-related deaths have risen dramatically from a low base, with 115 mentions in 2025 compared to 27 in 2020 and seven in 2015.
Policy failures and funding gaps
Charity leaders attribute the surge to policy failures, record cocaine production, falling prices, and increasing purity. Niamh Eastwood of Release said the UK's punitive approach prevents harm reduction services. Mike Trace of Forward Trust called the death rate a "national scandal." Will Haydock of Collective Voice warned that previous improvements are at risk due to government inaction and a funding freeze since the 2021 independent review by Prof Carol Black.
Crime and consumption trends
Wastewater analysis indicates surging cocaine consumption, now common in pubs, festivals, and workplaces. Police report a 10% rise in cocaine-associated crime since 2019, including assaults, domestic abuse, and dangerous driving.
