Between 2022 and 2023, cocaine-related deaths in England and Wales soared by 30%, according to the latest United Nations Office on Drugs and Crime report.
This could be an underestimate, as there is often a time lag of two to three years between drug deaths and the coroner’s assessment on which these statistics are based.
Not all deaths resulting from cocaine are included, and the long-term damage that eventually ends in a stroke or a heart attack will not show up in these reports.
One culprit is the precipitous rise in purity, which makes it easier to overdose by accident. Cocaine in Europe has on average a purity of over 60%, compared with 35% in 2009.
Today, even street cocaine rivals the top-end stuff of the 1980s. This may in part be the unintended consequence of government crackdowns on cutting agents such as benzocaine, a dental anaesthetic.
But the result is a drug that is often far stronger than users are expecting. This could be particularly true of generation X, who came of age at a time of much milder cocaine: the highest rate of recent deaths in England and Wales is among men aged 40 to 49.
Another factor is price, which, despite inflation, has not budged for years. This is partly because supply is up in producer countries, partly because cocaine has a known street price: raise it, and customers go elsewhere; drop it, and they suspect something is wrong with the product.
If cocaine is better and cheaper, more people try it. A larger pool of users means more with undetected heart issues that a dose of cocaine might suddenly exacerbate.
It is more often mixed with other drugs, rather than consumed reverently, by itself, as a treat. This ramps up the danger. It is now so cheap and prevalent that drinkers use it to temper the effects of alcohol, in order to drink more. And to fill the gap left in the higher end of the market, there are complicated cocktails.
One important aspect of the death rate comes down not to the drug itself but to human psychology. Cocaine is increasingly normalised. It may be more dangerous than ever, but the more people take it, the more commonplace it seems, and the safer they assume it to be. In this way, a vicious cycle is created: once there is a surge in cocaine use, it tends to be perpetuated.
Two things might work: harm reduction and data-driven education. At present, treatment centres are mostly set up to help with opiates, and there are no substitute drugs with which to treat cocaine addicts. There is some evidence that giving young adults information about how drugs affect the brain, backed up by reputable neuroscientific research, made them less likely to dabble.
However, another psychological block stands in the way of all this. People tend to be reluctant to spend money to help drug users.
In the 1980s, taxpayers were persuaded to fund harm-reduction programs only because injecting heroin was associated with the wider spread of HIV.
Then, under Tony Blair, spending on drug treatment was framed as a means to reduce crime.
Can today’s voters be convinced that it is worth helping coke-addled 40-year-olds not to die?
