Cocaine Now Tops Heroin in England and Wales Drug Deaths

Cocaine has overtaken heroin as the leading single cause of drug deaths in England and Wales for the first time. Deaths linked to cocaine have nearly quadrupled in a decade, according to new Office for National Statistics figures.

5,519 deaths and a first fall since 2012

A total of 5,519 drug poisoning deaths were registered in 2025. That is 92.4 deaths per million people, down from 93.9 a year earlier and the first annual fall since 2012. Cocaine was mentioned in 1,233 cases, slightly fewer than the year before. Heroin or morphine was linked to 1,210, which was also a fall.

Cocaine was linked to more than one in five of these deaths. Deaths tied to opiates and opioids combined are still higher than those tied to cocaine. The ONS also notes a lag between a death and its registration.

Ketamine deaths hit a record

Ketamine was referenced in a record 115 deaths, almost double the number in 2024 and up from seven a decade earlier. Dr James Morgan of London Metropolitan University links the rise to lower prices and the drug becoming normalised. He adds that some young users are now becoming dependent on ketamine and developing acute problems, bladder damage among them.

A widening regional gap

The overall rate hides a growing divide. The rate in the North East is more than twice as high as in London. The steepest rises came in former industrial areas, including the North East, Wales, Yorkshire and the Humber, the North West and the East Midlands, where poverty and unemployment go back to the 1980s.

Morgan describes increasing polarisation, with the poorest regions falling behind. He says total drug deaths in England and Wales have roughly doubled since 2012. Elsewhere in the UK, Scotland's figures rose 11% in 2025, the worst mortality rate in Europe, and Northern Ireland saw a 7.1% rise between 2021-23 and 2022-24.

Purity, potency and what counts as a cocaine death

Charities blame the rise in cocaine deaths on higher purity and wider availability. Mike Trace, chief executive of the Forward Trust, adds that very strong synthetic opioids called nitazenes are reaching the market. Hundreds of deaths in the UK have been linked to nitazenes, which can far exceed heroin in strength.

Morgan notes that the cocaine count includes people who injected the drug or smoked crack in combination with opioids or counterfeit pharmaceuticals, not only those who snorted it. He cautions against over-reading the small fall: cocaine deaths remain roughly four times the 2015 level.

Tom Powell and Nyk Irvin lost their brother Anthony Irvin, 52, in Ramsgate in September 2025. They believe contaminated drugs caused his death but say delays in blood testing mean they will never know for sure.

Our Take

A falling national rate can mask a worsening picture in particular places. The regional gap and the spread of potent synthetic opioids point to risks that averages do not capture. Local data on where cocaine and ketamine deaths are rising fastest would show whether prevention and treatment reach the areas that need them most.

Source: BBC News