Drug poisoning deaths have surged to a new record level, driven in part by a jump in fatalities involving cocaine.
Official statistics show 3,744 deaths involving both legal and illegal drugs were registered in England and Wales last year - the highest number since comparable records started in 1993.
Of those, 2,593 (69%) - or more than two-thirds - were classed as drug misuse deaths.
The figures, published by the Office for National Statistics (ONS), show there were 371 deaths involving cocaine - a rise of 16% on 2015.
Statisticians said rising levels in the purity of cocaine could be one explanation for the increase in deaths involving the drug.
Estimates based on the Crime Survey for England and Wales indicate that the proportion of adults aged 16 to 59 using the drug in powder form has remained broadly steady at just over 2%.
The ONS report said: "The National Crime Agency reports that there was a significant increase in both crack and powder cocaine purity at all levels in 2016, including user-level, which may partly explain the increase in deaths relating to cocaine."
Cocaine-related mortality rates have been increasing year on year, reaching a record high of 6.4 deaths per one million population.
The majority of fatalities linked to the drug occur in men aged 30 to 49, the figures show.
Evidence to distinguish the type of cocaine taken is rarely provided on death certificates.
In contrast to cocaine, deaths linked to heroin and/or morphine remained stable last year - with 1,209 compared with 1,201 registered in 2015.
There were rises in deaths involving the powerful painkiller fentanyl (from 34 in 2015 to 58 in 2016), paracetamol (from 197 to 219) and new psychoactive substances (NPS, from 114 to 123).
NPS typically mimic "traditional" drugs such as cocaine, cannabis and ecstasy, and were widely known as "legal highs" before laws criminalising their production, distribution, sale and supply were introduced last year.
People aged 40 to 49 had the highest rate of drug misuse deaths in 2016, overtaking those aged 30 to 39.
The highest mortality rate from drug misuse was in the North East with 77.4 deaths per 1 million population, a 13% increase from 2015, while the lowest rate was in the East Midlands with 29.1 deaths per 1 million population.
The figures prompted criticism of the Government's drugs policy.
Martin Powell, of the Transform Drug Policy Foundation, described the Home Office's approach as "scandalous".
He said: "The Government must accept responsibility for record numbers of people dying from overdoses year after year.
"Other countries value the lives of vulnerable people who use drugs enough to implement and fund many measures proven to save lives, like decriminalising drug users, safer drug consumption rooms and prescribing heroin."
The definition of a drug misuse death is either one where the underlying cause is drug abuse or drug dependence, or a death where the underlying cause is drug poisoning and where any substances controlled under the Misuse of Drugs Act 1971 are involved.
Figures on individual substances are based on the numbers of drug-related deaths were they are mentioned on the death certificate.