Drug poisoning deaths fall for the first time since 2012, as cocaine overtakes heroin
Registrations of drug poisoning deaths in England and Wales totalled 5,519 in 2025, and cocaine overtook heroin or morphine as the substance mentioned most often, a first since the series began in 1993.
The count of drug poisoning deaths registered across England and Wales turned down in 2025, the first such fall in over a decade, according to figures the Office for National Statistics published on 4 November. Registrations totalled 5,519, which is 46 fewer than the 5,565 recorded for 2024. Expressed as an age standardised rate, mortality stood at 92.4 per million people, down from 93.9 per million the year before. The statisticians describe it as the first annual decrease in the rate since 2012, ending a run of 12 consecutive rises, while noting the rate stayed close to its 2024 level.
The headline figure comes with a significant caveat about timing. The statistics are based on the year in which a death was registered, and because of long delays between a death occurring and its registration, 62.7 per cent of the deaths registered in 2025 occurred in previous years. On the separate occurrence basis, which uses a consistent 18 month registration period for each year, there were 5,203 drug poisoning deaths in England and Wales in 2024, a rate of 87.5 deaths per million people, unchanged from 2023.
Cocaine was the substance named most often in the 2025 registrations, featuring in 1,233 deaths, ahead of heroin or morphine at 1,210. The ONS says cocaine overtook heroin or morphine for the first time since the series began in 1993. Opiates and opioids remained the most frequently mentioned substance group overall, involved in 2,324 deaths, 11.3 per cent fewer than in 2024. Of the total, 3,615 deaths were classified as drug misuse, a rate of 60.6 deaths per million people, down from 63.1 per million in 2024, and people aged 40 to 49 continued to have the highest rate, at 141.4 deaths per million.
These deaths were preventable.Simon Phillips, chief executive of WithYou
The overall fall also conceals a widening gap between men and women. Mortality among men rose to 130.0 per million in 2025, while the female rate dropped to 56.6 per million. At 2.3 times the female rate, the male rate in 2025 showed a wider gap than in 1993, when it stood at 1.5 times as high.
Regional differences remain stark. The North East kept the highest rate of any English region even as its rate fell sharply, from 167.6 deaths per million people in 2024, down to 135.2 in 2025. The bulletin singles that fall out as the largest decrease among the English regions. London, by contrast, recorded the lowest rate of all, at 58.3 per million. In England as a whole there were 5,078 registered deaths, a rate of 89.5 per million, while in Wales there were 422 deaths, a rate of 141.3 per million, 0.6 per cent higher than the Welsh rate in 2024.
The treatment charity WithYou responded to the figures by calling for a dedicated drugs minister and a national drug checking service in England. Its chief executive, Simon Phillips, said: "These deaths were preventable." He added: "Any fall is welcome, but even one life lost is too many." The charity noted that responsibility for drugs policy is spread across at least six government departments, and pointed to the recommendation in Dame Carol Black's independent review that a single responsible minister be appointed to hold the government to account.
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