Deaths from drug poisoning in England and Wales have reached a record high, with a growing number of people dying after using cocaine and opiates, data shows. Charities said the figures showed there was a public health emergency, with the pandemic negatively affecting those with addiction problems. In 2020, 4,561 people died from drug poisoning – the equivalent of 79.5 deaths per million people. This is 3.8% higher than figures for 2019 and the highest number since records began in 1993. Two-thirds (2,996) of drug poisoning deaths in 2020 were related to drug misuse, accounting for 52.3 deaths per million people. Men accounted for more than two-thirds of deaths from poisoning in 2020, a disparity consistent with previous years. The highest rate of drug misuse deaths was found in those aged 45 to 49, closely followed by those aged 40 to 44. Approximately half of all the deaths from poisoning in 2020 involved an opiate – pain relief medication such as codeine and fentanyl – and 777 deaths involved cocaine, which is 9.7% more than 2019 and more than five times the number recorded a decade before. The rate of cocaine-related deaths among women has increased by more than 800% in the last 10 years, from 16 deaths in 2010 to 158 deaths in 2020. The latest English and Welsh drugs misuse statistics show Scotland’s rate of drugs deaths – those related to misuse and addiction – continues to be far higher than in other UK nations. Last week National Records of Scotland, the statistics agency, said in 2020 a record 1,339 people died from drug misuse. The new ONS data shows that Scotland’s per capita rate of drugs fatalities is 4.8 times higher than in England and Wales. Eytan Alexander, a recovering drug addict and chief executive of UK Addiction Treatment Centres, said the rise in England and Wales was sad but not surprising, with cocaine-related deaths “especially unsurprising … given that [the drug] is so readily available and as easy to order as a Deliveroo”. “We’re living in a parallel pandemic: a drug, alcohol, and mental health pandemic that has only worsened due to the virus. Enough is enough … we need to come together as a society and take real action.” Rates of drug-related poisoning were 60.9% higher in 2020 than in 2010. The rate has increased every year since 2012; the increase from 2019 was not statistically significant. Dr Emily Finch, the vice-chair of the addictions faculty at the Royal College of Psychiatrists, said years of cuts had left addiction services ill-equipped. She said more funding was needed “and people living with a drug addiction must have access to the mental health support they desperately need”. Clare Taylor, the national director of operations at Turning Point, which runs drug and alcohol recovery services, said the figures showed a public health emergency that needed an immediate response. “Covid-19 has impacted on the nation’s mental health, but the effect of isolation, financial insecurity and fear has hit many of those who were already vulnerable, including people with a history of drug or alcohol problems, and some people have not received the support that they needed,” she said, adding that austerity and cuts had also prompted a rise in drug-related deaths. “Every drug or alcohol-related death is preventable, and our thoughts are with anyone who has lost someone this way.” There have been increasing numbers of deaths involving benzodiazepines in 2020 (a rise of 19.3% compared with 2019; from 399 to 476 deaths), pregabalin (a rise of 41%; from 244 to 344 deaths), gabapentin (a rise of 32.6%; from 89 to 118 deaths) and zopiclone (a rise of 4.3%; from 140 to 146 deaths). People born between 1970 and 1979 have consistently had the highest rates of drug misuse deaths for the past 25 years. Mark Moody, the chief executive of the charity Change Grow Live, also called for immediate action. “For things to improve, we must directly challenge the stigma faced by people who use drugs. This starts by recognising that drug dependency is a chronic health condition which must be integrated alongside NHS services, criminal justice pathways and housing support.” In 2020, the highest rate of drug misuse deaths was in the north-east, while the lowest rate was in London. The north-east has had the highest rate of drug misuse for the past eight years and has a statistically significantly higher rate than all other regions of England.