Data from the Office for National Statistics shows significant shifts in drug-related mortality across England and Wales. Cocaine was mentioned in 1,233 registered drug poisoning deaths in 2025, surpassing the 1,210 deaths linked to heroin or morphine. This marks the first time cocaine has become the leading single substance associated with drug poisoning deaths. The increase represents a broader trend, with cocaine deaths having nearly quadrupled over the preceding decade.
Ketamine-linked fatalities reached a record 115 deaths in 2025, nearly doubling compared to the year before. Deaths from ketamine have risen substantially from seven fatalities a decade earlier. Experts attribute this increase to lower prices and normalization of the drug’s use, with reports of growing dependency among young people and associated health complications including bladder damage.
The overall drug poisoning death rate in England and Wales was 92.4 per million people in 2025, comprising 5,519 total registered deaths. This represents a decline from 93.9 deaths per million the previous year, marking the first annual decrease since 2012. However, specialists emphasize that absolute numbers remain elevated, with total drug fatalities in the region roughly doubling since 2012.
Regional disparities have become increasingly pronounced, with death rates more than twice as high in the North East compared to London. The steepest increases occurred in formerly industrial areas experiencing high poverty and unemployment, including the North East, Wales, Yorkshire and the Humber, the North West, and the East Midlands. Experts point to increased drug purity and availability as contributing factors, along with the proliferation of synthetic opioids such as nitazenes, which can be significantly more potent than heroin.
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