There were 5,519 deaths related to drug poisoning registered in England and Wales last year, according to the latest ONS figures – a small drop from 2024’s total of 5,565 and the first annual decrease since 2012. Of these, 3,615 deaths were related to drug misuse.
Cocaine was the most frequently mentioned specific substance, with 1,233 deaths – more than the 1,210 heroin or morphine deaths. However, opiates and opioids overall remain the most frequently mentioned substance group, implicated in 2,324 deaths.
People aged 40-49 continue to have the highest death rate, while the gap between male and female mortality has widened. Males accounted for 72 per cent of drug misuse deaths. Although the death rate in the North East saw the largest decrease of any English region, it remains the highest and is 2.3 times the rate of London. The death rate in the South West, meanwhile, increased by 16 per cent.
Long delays between the date of death and date of registration mean the figures are largely based on the year the deaths were registered, ONS points out, with more than 60 per cent of the deaths having occurred in previous years. Information on the specific drugs involved is not always available from the death certificate, it adds, with some recording general terms like ‘drug overdose’ or ‘multiple drug toxicity’. More than a fifth had no specific substance information recorded, and ONS does not have access to post-mortem reports or toxicology results.
Excluding deaths where no specific substance information was recorded, opiates and opioids were mentioned in 54 per cent of drug-poisoning deaths in 2025, down from 60 per cent in 2024. There were 308 deaths involving a new psychoactive substance registered, again slightly down on 2024. Deaths involving synthetic cannabinoids more than doubled, from 44 to 95 – the highest number ever recorded. Deaths involving nitazenes, however, fell from 195 in 2024 to 150 in 2025. The number remains almost three times higher than in 2023, ONS points out. Protonitazene was the most frequently mentioned nitazene, recorded in 94 deaths.
Ketamine was mentioned in 115 deaths, compared to 27 in 2020 and seven in 2015, while pregabalin was mentioned in 581 deaths. ‘Although this was lower than the 617 deaths recorded in 2024, it was more than six times the 90 deaths recorded in 2015,’ ONS says.
While ‘any fall’ was welcome, the deaths were preventable with the right support, treatment and policy-making, said WithYou CEO Simon Phillips. ‘Drugs policy needs political leadership. Responsibility is spread across at least six government departments, with no single minister in charge. Dame Carol Black’s independent review recommended appointing a single, responsible minister to hold the government to account. I urge the government to appoint a dedicated drugs minister with the authority to drive action across central government.’ There was no single quick fix, he added, with drug deaths ‘bound up with homelessness, poverty, poor mental health, unemployment, crime and the pressure on the NHS’. The government could not ‘meet its goals on any of these without taking drug harm seriously’.
The increase in cocaine deaths was a ‘direct result of policy failures both in the UK and internationally’, said Release executive director Niamh Eastwood. ‘Drugs such as cocaine are more available, cheaper and purer than ever. This is a public health emergency that is driving down life expectancy and disproportionately impacting our most deprived communities. It demands a national response. We urgently need to scale up harm reduction, including allowing drug consumption rooms, and end the criminalisation of people who use drugs if we are to remove the barriers that are literally killing people.’
The ‘deeply shocking figures’ highlighted a major crisis, said Abbeycare service manager Lee James, with ‘more than 100 people still losing their lives in England and Wales every week. If we are serious about reversing this trend, the government must recognise the importance of investing in rehabilitation services and aftercare provision. More funding is needed to ensure that people struggling with addiction can access the treatment, support, and ongoing care they need, regardless of their circumstances.’
The government needed to re-state its commitment to reducing harm from drugs, added Collective Voice chief executive Will Haydock. ‘For over two years the government has been largely silent on addiction, and has paused the planned investment programme, freezing funding at year three levels rather than continuing to follow the path laid out by the Independent review of drugs, which has amounted to a real terms cut at a time when we are trying to support more people in treatment than ever before. We urgently need a new drugs strategy with clear priorities, including reducing drug-related deaths. If we get our response to alcohol and other drugs right, we can save and improve hundreds of thousands of lives. The fact that cocaine is now the single most mentioned substance in the latest ONS figures, overtaking heroin, emphasises how harms and challenges continue to develop. The government’s approach must similarly continue to develop in response – which means a new strategy.’
Deaths related to drug poisoning in England and Wales: 2025 registrations available here