6 New Drug Death Trends—and What They Say About Modern Britain

The latest drug poisoning stats for England and Wales have just been released. As someone who tracks these things, they are never a fun read, but this year they’re particularly sobering. The overall number of deaths soared to 5,448 during 2023—a continuation of year-on-year rises since 2012, when a 21st century low of 2,597 people lost their lives to illegal substances.

The situation reflects that of Scotland—whose own drug poisonings rose a dizzying 12 percent this year—and turns a mirror on a British society that was recently decried as the “literal sick man of Europe” in a cross-party commission into the nation’s health.

So, what do the details tell us about our green and pleasant lands, beyond the fact we really like getting dangerously smashed? VICE spoke with a trio of drug industry experts to find out.

Cocaine: The Deadly People’s Powder

Beak. Bugle. Gak. Gear. Whatever you call it, Britain loves it, and the rise of cocaine-related deaths was the most eye-catching take-home from this year’s stats, with an increase of 30.5 percent in just one year (from 857 in 2022 to 1,118 in 2023). This is a continuation of an upward trend: in 2011, there were just 112 coke-related fatalities.

You only need to watch the advert for Danny Dyer’s new film Marching Powder—in which he plays an aging football hooligan desperately struggling to give up coke (as well as masturbation and FIFA)—to observe Britain’s toxically co-dependent relationship with the stuff. It’s also worth noting that while, overall, the biggest demographic for drug misuse deaths is men from Generation X, cocaine’s biggest victim cohort is actually millennials.

Importantly, Harry Sumnall, Professor of Substance Use at Liverpool John Moores University, points out that these stats don’t differentiate between crack and cocaine. “But significant proportions of those deaths will be associated with cocaine powder and directly related to that,” he says.

The Sisyphean nature of cocaine and its hand-in-glove coziness with other substances, especially booze, is surely part of the appeal for a British culture that created ‘the sesh.’

Cocaine’s harms have also increased in tandem with its quality. In 20019, the average street purity was just 20 percent, while a 2018 report pegged it at 63 percent—nowadays, many street or online dealers offer a range of strengths, scaling up to near 100 percent proof. “It’s higher quality from a consumer perspective,” says Sumnall. “But you’re being exposed to a higher strength over a longer period of time, and that will have a more toxic effect.”

Drugs of Despair, Deprivation of Services

Traditionally, opiates have contributed around half of the overall drug deaths total. This has persisted, with them taking 2,551 lives in 2023—12.8 percent more than last year.

For the first time, we’ve also seen a really significant presence of nitazenes: the synthetic opioid said to be hundreds of times stronger than fentanyl, which has been linked to at least 248 deaths since June 2023, according to the National Crime Agency.

Opiates and opioids are often, perhaps insensitively, denoted as “drugs of despair.” So it’s maybe not surprising that the North East—where deindustrialisation has taken its scythe to employment and opportunity—has had the highest rate of opiate and opioid deaths every year for the last 11. This year, the rate is three times higher than in London.

“Drug-related deaths are socioeconomically patterned,” says Sumnall, adding that “the public health challenge is a general challenge about making cities, towns, and communities healthier.” Austerity-based policies have decimated drugs services and while he praises Professor Dame Carol Black’s 2021 drugs review, which allocated an extra £552m to this area of provision, Sumnall suggests that “there’s been arguments made that, even though that funding is welcomed, it’s not sufficient because it pretty much just takes us back to where we should have been, had there not been any cuts to funding and increased patterns of harm.”

Ketamine: the Drug of Disconnection for a Disconnected Era

Despite being stashed in the underwear of every raver from Block9 to Berghain, for some reason, ketamine isn’t traditionally included in the annual stats around drug deaths. Nevertheless, there has been a fivefold increase in ket-using adults reporting to treatment services. Usage has been spiking, with 3.8 percent of 16 to 24-year-olds sniffing it in 2022/23 (up from 1 percent in 2016). Analysis of deaths from 2005 to 2019 showed they rose from around 5 per year at the start of this timeframe, to around 30 per year after 2016.

Adam Waugh is co-founder of PsyAware, a support organization for psychedelic users and practitioners. Whilst he makes clear that “the vast majority of users don’t experience harm” he warns that “ketamine can be dependency forming.”

Ketamine’s other secret sauce is its dissociative properties, which perhaps make it a perfect drug for the post-pandemic, doom-scroll era. “The effect of the last five years—with COVID-19 and its disruption to young people’s lives, not to mention the increasing ubiquity of devices—has made everything less connected,” says Waugh. “I don’t think it’s a coincidence that some of the drugs that are becoming more widely used, including ketamine, are drugs of disconnection.

“It allows you to block out emotional pain.”

Prescription Unfulfilled

As well as ketamine, Waugh also includes benzodiazepines and other normally prescribed anxiolytics (anxiety medications) in his suite of disconnecting substances for a disconnected epoch. These include the likes of diazepam, alprazolam (Xanax), or pregabalin, and there was a very slight increase (from 512 from 509) for benzos in this year’s death data.

Whether it’s a rough sleeper poly-using prescription drugs with heroin, crack or booze, a student self-medicating anxiety, or a raver trying to nod off after a night out, taking them has never been easier or more normalized. A quick scan of Telegram finds pills starting at around £1 a pop, while buying one blister pack of 30 pills reduces the unit price to 75p. This makes them cheap enough to survive a cost-of-living crisis, while conveniently salving the many blights of a deprived society and carrying an aura of respectability.

“They can feel more legitimate, in a way,” says Ian Hamilton, Associate Professor of Addiction at the University of York. “People can think it’s safer because they’re taking a prescription drug, but of course that’s no guarantee at all because it depends who’s supplying it.

“They’re not as stigmatized as a drug like heroin, and you can do them discreetly.”

Previously, prescription drugs sold illegally tended to be genuine products diverted from pharmaceutical settings. Waugh says they’re now often made in India or China—a fake, branded, blister pack of Bensedin diazepam or the opiate Oxycodone will often be a lottery in terms of its actual contents. WEDINOS, the Welsh drug testing service, have found the deadly synthetic opioid nitazene laced in both across recent months.

Is the Message Getting Through About High Strength Pills?

MDMA-related deaths jumped from 51 In 2022 to 79 in 2023—a 35 percent increase. London nightclub fabric recently posted about a series of hospitalisations from high strength pills, a message reinforced by drugs checking agency The Loop who, last weekend, released an alert that one in four of ecstasy pills they were testing contained over 200mg—roughly twice a standard adult dose.

After a Covid-induced slump in MDMA and ecstasy strength, these new cornea-rattling gurners offer a challenge to harm-reduction services and drugs workers trying to educate people on the new rules—most importantly, start with a quarter. But is the great British public listening?

“It seems to me that most people who take pills know about the strength and are pretty responsible,” says Waugh. Of the 79 deaths, 40 were under 30 years of age and 16 of those were under 20. “There’s a subgroup who still take pills in very harmful ways,” he says.

Booze: the Most Harmful Drug of All?

With the increase in cocaine-related fatalities, the tendency of heroin users to have a history of alcohol use or misuse, and the most recent stats that revealed booze-specific deaths reached a record 10,048 in 2022, the question continues to linger: is alcohol—great smoother of social anxiety, foundation stone of “democracy”—the UK’s most harmful drug of all?

“I’d say so,” says Ian Hamilton. “We’ve had a real problem since the pandemic. During Covid, there were roughly three groups: a third of people who were abstinent and pretty much continued. A third you’d describe as moderate, who increased slightly. Then there’s the last third, who were already drinking at risky levels and drank even more. That’s unlikely to come down and that’s the group that really worries me.”

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