The number of deaths from cocaine use in England and Wales has nearly quadrupled in a decade, overtaking those attributed to heroin for the first time.
Cocaine was linked to more than one in five drug poisoning deaths registered in 2025, more than any other single substance, with charities blaming its increased purity and availability.
Meanwhile a record 115 ketamine-linked deaths were registered, almost twice as many as in 2024, according to Office for National Statistics data, external.
The overall rate of drug deaths fell for the first time since 2012. But experts pointed out regional inequality was growing, with the rate of such deaths 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, the equivalent of 92.4 deaths per million people.
Of these, 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 marked a fall from the previous year’s level.
However, deaths linked to opiate and opioid drugs combined were still higher. The ONS also said there was a lag between deaths occurring and being registered.
The fatality rate fell from 93.9 deaths per million people a year earlier, representing the first annual decline since 2012.
In September, National Records of Scotland said drug deaths there had risen by 11% in 2025 on the year before, marking the worst mortality rate in Europe,
In May the Northern Ireland Statistics and Research Agency said drug-related deaths rose by 7.1% between 2021-23 and 2022-24, external.