Cocaine has overtaken heroin for the first time as the drug most often linked to fatal poisonings in England and Wales, according to new figures from the Office for National Statistics (ONS). The data has prompted renewed debate over whether Britain's drug laws are making the crisis worse rather than better.
The ONS data, published on November 4, shows 5,519 deaths related to drug poisoning were registered in 2025 in England and Wales, the equivalent of 92.4 deaths per million people. That was a slight fall on 2024, when 5,565 deaths were recorded (93.9 per million), and marked the first annual decrease in the age-standardised mortality rate since 2012, following 12 consecutive annual increases.
Cocaine deaths at historically high levels
Cocaine was the most frequently mentioned specific substance in the 2025 registrations, appearing in 1,233 deaths and overtaking heroin or morphine, which were mentioned in 1,210 deaths. Although cocaine deaths were down slightly from 1,279 in 2024, the ONS said they remain historically high and are more than eight times higher than in 2010, when 144 deaths involved cocaine.
The figures also show cocaine deaths are overwhelmingly male. Of the 1,233 deaths involving cocaine in 2025, 984 were men (79.8%) and 249 were women (20.2%).
Campaigners call for regulation
Campaigners say the black market is fuelling the danger. Steve Rolles, senior policy analyst at the Transform Drug Policy Foundation, told the Daily Star: "All drugs are risky but illegal production and supply only increases those risks - sensible public health lead regulation can moderate those risks."
Rolles said regulation creates "opportunities to minimise those risks" because substances would be of "known dosage and purity", reducing the chance of unknown strength or adulteration with deadly drugs such as fentanyl. He added: "Regulated drugs say exactly what they are on the package alongside health risk and harm reduction information that you simply do not receive with drugs bought on the streets."
He also said legal sales could be limited to adults and handled by "pharmacist style trained individuals" able to give advice and direct people to support. Asked how deaths could be reduced in the short term, Rolles said: "We would like to see an appropriate level of investment in public health lead services for people who use cocaine and other drugs", including prevention and education for vulnerable groups, honest risk information, and treatment when needed.
Regional divides and harm reduction measures
Rolles claimed: "Punitive enforcement measures and the war on drugs have only driven up cocaine-related deaths by more than 100 fold since 1993." He said even before any move to legal regulation, lives could be saved through drug checking services, like those recently opened in Bristol and London, so users know what they are taking.
He added that for people smoking crack or injecting cocaine, "which is where most of the deaths are occurring", supervised consumption facilities are "vital" because overdoses are more likely to be fatal when someone is alone.
The ONS figures also highlight deep regional divides. The North East continued to have the highest drug-poisoning mortality rate in England at 135.2 deaths per million people in 2025, while London had the lowest at 58.3. Rolles said: "The harms of both illegal drug use and punitive drug enforcement land most heavily on vulnerable communities already", adding the gap shows how concentrated the crisis has become.
