Cocaine has overtaken heroin as the leading single substance linked to drug-poisoning deaths in England and Wales, after cocaine-related deaths nearly quadrupled in a decade, the BBC reported. Cocaine was mentioned in more than one in five drug-poisoning deaths registered in 2025, more than any other single substance, with charities blaming increased purity and availability. A record 115 ketamine-linked deaths were also registered, almost twice as many as in 2024, according to the Office for National Statistics. The overall rate of drug deaths fell for the first time since 2012, but experts said regional inequality was growing, with the rate more than twice as high in the North East as in London.
There were 5,519 drug-poisoning deaths registered in 2025 in England and Wales, or 92.4 deaths per million people. Cocaine was mentioned in 1,233 cases, slightly fewer than the previous year but higher than the 1,210 deaths linked to heroin or morphine, which also fell. Deaths linked to opiate and opioid drugs combined were still higher. The ONS noted a lag between when deaths occur and when they are registered. The fatality rate fell from 93.9 per million a year earlier, the first annual decline since 2012. In September, National Records of Scotland said drug deaths there had risen 11% in 2025, the worst mortality rate in Europe. In May, Northern Ireland's statistics agency said drug-related deaths rose 7.1% between the periods 2021-23 and 2022-24.
Dr. James Morgan, who specializes in addiction and mental health at London Metropolitan University, said that while there had been a slight decrease, "the numbers remain objectively high," with total drug fatalities in England and Wales roughly doubling since 2012. "What we are seeing is increasing polarisation and growing inequalities, where the poorest regions are falling behind, and more affluent regions doing better," he said. The steepest increases were in formerly industrial areas with high poverty and unemployment dating back to the 1980s, including the North East, Wales, Yorkshire and the Humber, the North West, and the East Midlands.
The verified figures are registrations, not a real-time count, and a mention of cocaine on a death record does not always mean it was the only drug involved. The news is a grim crossover in the official statistics, a first decline in the overall rate since 2012, and a widening geographic gap, not a declaration that the drug-death crisis is over. Charities have tied the cocaine rise to higher purity and easier supply, a combination that can make a drug both more appealing and more dangerous than users expect.