Cocaine overtakes heroin and morphine in drug deaths, while overall rate falls

Cocaine was mentioned in more drug poisoning deaths registered in England and Wales in 2025 than heroin or morphine, according to figures from the Office for National Statistics. It is the first time cocaine has overtaken either substance individually, while the overall rate of drug deaths fell for the first time since 2012.

There were 5,519 drug poisoning deaths registered in 2025, equivalent to 92.4 deaths per million people. Cocaine was mentioned in 1,233 cases, slightly fewer than the previous year but above the 1,210 cases involving heroin or morphine.

The figures do not mean cocaine caused more deaths than all opioids combined: deaths linked to opiate and opioid drugs together remained higher. The ONS also cautioned that there is a time lag between deaths occurring and being registered.

The rate fell from 93.9 deaths per million in 2024, but remained high. Dr James Morgan, an addiction and mental health specialist at London Metropolitan University, said total drug fatalities were roughly double their 2012 level. He warned that the small fall in cocaine-linked deaths should not be over-interpreted: they remained roughly four times the 2015 figure.

Regional differences were pronounced. The rate was more than twice as high in the North East as in London, and the steepest increases were reported in several formerly industrial areas, including Wales, Yorkshire and the Humber, the North West and the East Midlands.

Ketamine was mentioned in a record 115 deaths in 2025, almost twice the previous year’s figure and up from seven a decade earlier. Morgan linked the increase to lower prices and more normalised use, and said there were growing reports of young people developing dependence and acute health problems, including bladder damage.

Charities have pointed to greater cocaine purity and availability as contributing risks. Mike Trace, chief executive of the Forward Trust, also cited the spread of potent synthetic opioids known as nitazenes. The figures record substances mentioned in drug poisoning deaths; they do not establish that any one substance was the sole cause in every case.