About half of the deaths involved opiates.
Drug-related deaths in England and Wales were at their highest last year since records began in 1993, official statistics show.
A total of 4,561 drug-related deaths were registered in England in 2020, the Office for National Statistics (ONS) revealed on Tuesday.
The agency flagged however that around half of the deaths occurred in 2019 but death registration delays — lengthened because of the pandemic — saw them included in the 2020 figures.
The rate of drug-related deaths has increased in England every year since 2012 with the latest figure standing 60.9% higher than in 2010.
There were 79.5 drug-related deaths per million people in 2020 but the rate for men was much higher — 109.7 drug poisoning deaths registered per million — than the 49.8 deaths per million observed for women.
Nearly two-thirds of deaths were caused by the misuse of prohibited drugs and approximately half of all drug poisoning deaths registered last year involved an opiate.
Cocaine was involved in the deaths of 777 people, which is 9.7% more than the previous year and more than five times the amount recorded a decade ago.
Heroin and morphine were the most frequently mentioned opiates with 1,337 deaths mentioning either one of these substances. Nearly a quarter of drug-related deaths last year did not mention any drug type on the coroner's certificate, mentioning instead "drug overdose" or "multiple drug toxicity."
Geographically, the highest rate of drug misuse deaths was observed in northeastern England (104.6 deaths per million), with the lowest rate observed in London (33.1 deaths per million).
The North East has had the highest rate for eight consecutive years. Wales, meanwhile, recorded its lowest level of drug misuse deaths since 2014 with a 9.1% year-on-year decrease. The ONS stressed however that "it is possible that death registration delays in Wales could be affecting the latest figures."
Age-wise, people born in the 1970s continued to have the highest drug-related death rate. Known as "Generation X", they have consistently had the highest rates of drug misuse deaths for the past 25 years, the ONS said.
This ageing cohort of drug users is "likely to be suffering from the effects of long-term drug use and becoming increasingly susceptible to a fatal overdose," the ONS also said.