Cocaine has become the deadliest drug in England and Wales, surpassing heroin for the first time in 2025, according to new data from the Office for National Statistics (ONS). The figures reveal a nearly fourfold increase in cocaine-related deaths over the past decade, with charities pointing to rising purity and availability as key drivers.

A Decade of Escalation

In 2025, cocaine was implicated in 1,233 deaths, more than any other single substance and slightly higher than the 1,210 deaths linked to heroin or morphine. This marks a significant shift from 2015, when cocaine-related deaths were roughly a quarter of what they are today. The ONS data also shows that cocaine was mentioned in over one in five drug poisoning deaths registered last year.

Overall, there were 5,519 drug poisoning deaths in England and Wales in 2025, equating to 92.4 deaths per million people. While this represents a slight decrease from the previous year's rate of 93.9 per million, it is the first annual decline since 2012. However, experts caution that the numbers remain alarmingly high, with total drug fatalities roughly doubling since 2012.

Regional Inequality Widens

Despite the overall decline, regional disparities are growing. The rate of drug deaths in the North East is more than twice that of London, with the steepest increases observed in former industrial areas grappling with high poverty and unemployment, such as Wales, Yorkshire and the Humber, the North West, and the East Midlands.

Dr James Morgan, an addiction and mental health specialist at London Metropolitan University, described the situation as one of "increasing polarisation and growing inequalities," where the poorest regions are falling further behind. He emphasized that the slight drop in cocaine deaths should not be overinterpreted, noting that cocaine-related fatalities are still quadruple what they were in 2015 and now exceed those from heroin or morphine.

Ketamine Deaths Double

The data also revealed a record 115 ketamine-linked deaths in 2025, nearly double the previous year and a stark rise from just seven a decade ago. Dr Morgan attributed this to lower prices and the normalisation of ketamine use, with increasing reports of young people developing dependencies and suffering severe health consequences, including bladder damage.

Mike Trace, CEO of the addiction charity Forward Trust, highlighted the role of potent synthetic opioids like nitazenes, which can be many times stronger than heroin and have been linked to hundreds of UK deaths. "We know that increasingly potent drugs like nitazenes are making their way on to the market. We know that established drugs like cocaine are growing in purity which means they come with much higher risks to users," he said.

A Family's Tragedy

For the family of Anthony Irvin, who died from drug poisoning in Ramsgate in September 2025 at the age of 52, the statistics are deeply personal. His siblings believe his death was caused by a supply contaminated with synthetic opioids, but delays in blood testing mean they may never know for sure. "Today's figures are shocking," said Tom Powell, Anthony's brother-in-law. "We are fighting to wake people up to the scale of the problem."

As the crisis evolves, the focus must remain on prevention, treatment, and addressing the underlying inequalities that fuel addiction.