There were 5,448 drug poisoning deaths registered in England and Wales last year, according to the latest figures from the Office for National Statistics (ONS) – up 11 per cent on 2022’s figure of 4,907.
More than 3,600 of the deaths were registered as drug misuse, with the highest death rate – as in the last 11 years – found in the North East, at three times higher than London’s rate.
Just under half of all deaths involved an opiate, while there was also a huge rise in deaths involving cocaine – more than 30 per cent up on the previous year, at 1,118. The number of cocaine-related deaths has now risen for 12 consecutive years, ONS states.
Among males, 3,645 drug poisoning deaths were registered in 2023, compared to just over 1,800 deaths among females. The overall death rate represents 93 per million, which is now double the rate in 2012. Delays in registration, however, mean that two thirds of 2023’s deaths actually occurred in previous years, ONS points out. Almost 380 deaths were registered in Wales last year, up from 318 the previous year.
The average age for drug misuse deaths was 44 for men and 47 for women. ‘People born in the 1970s continue to have the highest rates of drug misuse deaths,’ ONS states. ‘They are part of the cohort often referred to as “Generation X”, born between the late 1960s and early 1980s, who have consistently had the highest rates of drug misuse deaths for the past 25 years.’

ONS also points out that as it does not have access to post-mortem reports or toxicology results and depends instead on information provided by coroners, the figures for drug misuse and for specific substances will be underestimates. While opiates continue to be the most frequently mentioned drug type, more than half of all drug-poisoning deaths involve more than one drug, the agency adds, meaning that it is also not possible to ‘tell which substance was primarily responsible for the death’.
‘This devastating loss of life is deeply saddening, unnecessary and unacceptable,’ said Change Grow Live’s deputy chief executive Nic Adamson. ‘Without the hard work of frontline staff and volunteers in our own and other services, deaths would undoubtedly be even higher, and the strain on the NHS much worse. As mental health issues, financial struggles, inequalities, and dangerous synthetic drugs continue to fuel the crisis, we must do everything possible to make sure harm reduction services reach those most at risk. We are at a critical moment, and strongly urge the government to respond to the calls from the Association of Directors of Public Health and Collective Voice to continue its investment in the ten-year national drug strategy and increase public health grant funding in the autumn budget.’

The public health crisis of drug-related deaths was now ‘turning into a health catastrophe,’ stated Release executive director Niamh Eastwood, with the delays in registration and ever-increasing availability of powerful synthetic drugs meaning that the figures did not even ‘capture the catastrophic impacts’ of synthetic opiates. ‘Across England and Wales, those using drugs have been intentionally abandoned by the state,’ she said. ‘A growing number of adulterants within the drug supply have meant that drug supplies are more unpredictable than ever; more and more people are unknowingly exposed to a toxic drug supply, whether it be synthetic opiates or cocaine of unprecedented purity levels, with limited access to resources to stay safe. We must act now to prevent more deaths, suffering, and health harms.’ The government needed to scale up harm reduction interventions, including drug consumption rooms and drug checking services, she urged. ‘This is why we are calling on Wes Streeting and Yvette Cooper to implement reforms immediately.’
While the reasons behind the public health crisis were ‘deep-rooted and complex’, the new government needed to be ‘brave and bold’ added WithYou chief executive Simon Phillips. ‘To take this tragedy seriously we want to see guaranteed funding for high-quality evidence-based drug treatment and recovery services in the autumn budget, and a long-term commitment in the spring spending review. Steps to increase the supply and accessibility of naloxone must be implemented as soon as possible, and we want the government to go even further, and ensure it is available to all opiate users and their friends and family members too.’ Alongside provision of widespread drug-checking services and consumption rooms, the root causes of the crisis also need to be tackled, he said. ‘We cannot stop drug-related deaths if people don’t have safe places to live, access to health and mental health services, and a safety net for when they need it.’
Deaths related to drug poisoning in England and Wales: 2023 registrations available here