A slight drop in the number of drug deaths over a year in England and Wales is the first such news since 2012. Over the past decade, the grim trajectory has been upward; the annual figure of 5,519 has more than doubled since the 1990s. Given this trend, any fall is a relief. But the spike in deaths linked to cocaine, which has overtaken heroin for the first time, as well as evidence uncovered by the Guardian of a link with domestic violence, points to the need for a drugs policy that takes account of changing usage.
Nearly six in 10 drug tests on people arrested on suspicion of domestic abuse were positive for cocaine in the year to June, while a previous study found that 59% of suspects tested positive for cocaine or opiates. Links between domestic violence and alcohol have been highlighted by campaigners since the 19th century. In 2022, a UK government report found that alcohol and drug use featured in around a third of 127 domestic homicides it examined.
But while some of the issues thrown up by substance misuse are similar – increased paranoia and aggression placing partners and other relatives of abusers at risk – there are specific challenges around illegal drug use that ministers need to address. One woman told the Guardian that she had covered up her former partner’s cocaine use because she feared police would find out that she had also taken it. Charities are frustrated by the way that the criminal penalties for drug possession make it difficult to offer and access support.
In Scotland, which has the highest rate of drug deaths in Europe, a pilot treatment room is operating in Glasgow, though a sharp rise in deaths suggests that while such rooms may be a pragmatic harm reduction measure, they are not a panacea. In England and Wales, a drugs strategy was launched in 2021 following a review by Prof Dame Carol Black. But while the then Conservative government accepted her recommendation to invest in addiction treatment and research, funding has since been frozen – while wastewater samples and crime figures show that cocaine use has boomed. In the year to March 2025, the police and Border Force made 269,321 drug seizures – the highest on record.
The spending review next year offers a chance for a reset that ministers should take. While cocaine use has traditionally been associated with higher disposable incomes, there are five times more drug deaths in the most deprived areas compared with the least deprived ones (London has the lowest rate). Liverpool’s Alder Hey children’s hospital recently opened a clinic to treat under-16s who have injured their bladders by taking ketamine.
Police have an important role in tackling traffickers. But ministers must recommit to the “whole-system approach” proposed by Prof Black. Reducing drug deaths should be part of wider efforts at reducing socioeconomic health disparities. Research should focus on effective treatment, and seek to understand the link between cocaine and domestic abuse. The impacts of the illegal drugs market have altered in the past five years. It is time for the authorities to catch up.
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