Cocaine is now England and Wales' deadliest drug, killing 1,233

Cocaine just claimed a grim title. For the first time, it's the drug most often involved in drug-related deaths in England and Wales, according to Office for National Statistics figures — 1,233 deaths last year, or 22% of the total. That count covers cocaine in all its forms: powder, injected, and smoked as crack.

Overall drug poisoning deaths registered last year came in at 5,519 — 46 fewer than in 2024. Small comfort. The ONS says the numbers remain historically high, running at double the rate of a decade ago. The north-east took the hardest hit at 135.2 deaths per million people, while London logged the lowest rate at 58.3. In the most deprived areas, deaths ran five times higher than in the least deprived.

Cocaine's climb has been steep and relentless: deaths tied to the drug are now four times higher than a decade ago and eight times higher than in 2010. Older users are driving much of it, with 64% of registered cocaine deaths among people over 40 — the same age pattern showing up in treatment services. Wastewater analysis points to surging consumption, and cocaine is turning up more often in pubs, at festivals and in workplaces. The Guardian reported last week that police are logging more cocaine-linked crimes, with cocaine-related offences up 10% since 2019.

Ketamine is writing its own alarming curve. The drug was mentioned in 115 deaths last year, up from 27 in 2020 and just seven in 2015 — a dramatic jump from a very low base.

Niamh Eastwood, executive director of the drugs law charity Release, laid the blame on policy, calling the deaths a direct result of failures in the UK and abroad. She said cocaine production is at an all-time high and the drug is more available, cheaper and purer than ever, despite billions spent trying to disrupt the trade. Release also argues that the UK's punishment-first approach blocks harm-reduction services, leaving nothing practical for people who use cocaine.

Mike Trace, chief executive of the social justice charity Forward Trust, called the overall death rate a national scandal and said cocaine's rise to the top should surprise no one — pointing to record South American production, falling prices and rising purity. Will Haydock of the treatment campaigning charity Collective Voice warned that past gains are now at risk from government inaction, saying ministers have been largely silent on addiction for over two years and paused a planned investment programme, freezing funding at year-three levels. He called for a new drugs strategy with reducing drug-related deaths front and centre — the path laid out by Prof Carol Black's independent review, commissioned under Boris Johnson's government and published in 2021.