Drug misuse doesn’t just claim lives; it shatters families, leaves communities in ruins, and creates ripples of trauma that may never fade. It’s not just a headline or a statistic. It’s a father mourning his children, a mother behind bars, a family torn apart, and a society turning its back on the hard truths. The story of Kara Alexander is a harrowing example of drug-induced violence—a loving mother, driven to unimaginable actions by cannabis-induced psychosis, took the lives of her two beautiful sons, Elijah and Marley. Their innocent smiles, their fleeting potential, extinguished in a moment of madness.

This isn’t just about one family. It’s about the thousands of lives lost each year in the UK to drug-related causes, to addiction, to moments of violence that leave a lifetime of regret. It’s about communities destabilised by a crisis we fail to confront with the urgency it demands. Behind every grim number, there is pain, love, and loss. This article looks unflinchingly at the cost, through Kara’s devastating story, rising drug statistics, and the growing toll on families like yours or mine. How many more lives must be ruined before we open our eyes?

A Mother’s Psychosis and the Deaths of Her Two Sons

On 15 December 2022, two young brothers, Elijah (2) and Marley (5), were drowned in their own bath by the woman who should have protected them above all else–their mother, Kara Alexander. Once described as caring, affectionate, and gentle, Kara was sentenced to a minimum of 21 years in prison for their murders. The court heard she’d entered a cannabis-induced psychotic state after weeks, if not months, of daily “skunk” cannabis use.

The judge, Mr Justice Bennathan, called it “the stuff of nightmares”. No one suspected she was capable of such violence. Her actions have left a father without his children, a family shattered, and a mother who, in the judge’s words, “will mourn her sons for the rest of her life”.

Why is this always and forever ignored? Liberty at the expense of life? How many children must die before weed, pot, or dope are recognised not as a prior human right but as a risk with devastating consequences?

Drug-Induced Violence and Its Ripple Effects

The tragic deaths of Elijah and Marley are a stark reminder of the devastating consequences of drug-induced violence and psychosis. Kara Alexander, a mother once described as loving and gentle, drowned her young sons while in a cannabis-induced psychotic state, leaving her family shattered and a community grieving.

Record-High Drug Poisoning Deaths

According to the Office for National Statistics (ONS), 2023 saw 5,448 drug poisoning deaths in England and Wales–the highest since records began in 1993, and an 11% increase on 2022. The age-standardised mortality rate was 93.0 deaths per million–twice what it was in 2012

Dr. Niall Campbell, a consultant psychiatrist specializing in addictions, emphasizes that people often underestimate the true scale of drug-related harm. “I actually think those figures are an underestimate. “When drug-related causes claim lives, records often fail to capture them,” he notes. Drug misuse infiltrates all walks of life, spanning school gates, family homes, and middle-class dinner parties, without being limited to specific groups. “A significant number of people will be partying on coke, whether it’s in central London or at a middle-class dinner party in the Cotswolds,” Campbell observes.

Every drug-related tragedy creates ripples of pain, tearing apart families and destabilising communities. This growing crisis impacts all layers of society, making it imperative to confront the widespread toll of substance misuse with urgency and awareness.

Kara Alexander’s story is just one example of a growing crisis reflected in the alarming rise of drug poisoning deaths across the UK.

The Devastating Rise in Drug Misuse and Violence

Key facts/figures for reference (2023 ONS and official sources):

• 5,448 drug poisoning deaths in England and Wales (an 11% rise over 2022)
• Cocaine was involved in 1,118 deaths (a 30.5% rise from 2022, and nearly ten times higher than in 2011); 79.2% were males.
• Opiates (including heroin and morphine) were involved in 2,551 deaths (up 12.8% from 2022), representing 46.8% of all drug poisoning deaths.
• Polydrug use complicates matters further, with over half of deaths involving multiple substances.
• Drug misuse is widespread, affecting every segment of society

Which Groups Are Most at Risk?

• Death rates are highest among those aged 40-49 (147.3 per million), particularly Generation X, a cohort showing the highest rates for the last 25 years.
• The average age at death for males is now 44.5, with females at 47.5.
• The North East ranks as the UK’s drug misuse epicentre, with 174.3 deaths per million, compared to just 58.1 per million in London.

Drug Misuse Is Widespread and Underreported

• 9.5% of people aged 16–59 years (3.1 million) reported using a drug in the past year.
• Among 16- to 24-year-olds, the figure is 17.6%–approximately one million young adults.
• Cannabis remains the most used drug, with 7.6% of 16- to 59-year-olds (2.5 million) using it in the last year.

The Ageing Body and Substance Use: Ignoring the Risks

Substance use in older adults is an often-overlooked issue with potentially severe consequences. Many individuals in their forties, fifties, and beyond either continue using drugs from their youth or return to them “for old time’s sake.” According to Dr. Niall Campbell, a Priory consultant psychiatrist, this behavior can be dangerously misguided. “The typical scenario is a group of men in their fifties who say, ‘Come on, lads, let’s go to Ibiza and party like we did in 1999.’ The trouble is, their bodies can’t take it, and they end up facing severe cardiac problems, or even death. As you get older, every time you take cocaine you’re playing Russian Roulette.”

The ageing process brings significant physical changes that make substance use riskier. Cocaine, for instance, is particularly hazardous for older adults because of its cardiac toxicity. The drug spikes dopamine levels and speeds up heart rates, putting immense pressure on cardiovascular systems already weakened by age. This can lead to sudden and fatal outcomes. Yet, despite these risks, some still believe they can use drugs as they did in their younger years, often ignoring even the most visible warning signs. Dr. Campbell explains, “These people still feel young at heart. They think they can still do what they used to in the old days. Unfortunately, they can’t. Even if they’re aware of the health risk, they choose to ignore it.”

The sobering statistics reveal that middle-aged and older adults face the highest death rates from drug poisoning, reflecting these physiological vulnerabilities.

Middle-Aged Adults Face the Highest Death Rates from Drug Poisoning

These physiological risks are reflected in data that underscores the vulnerability of middle-aged and older adults to substance-related harm. Across England, Wales, and other Western countries, individuals in their 40s and 50s record the highest death rates from drug poisoning. The statistics are sobering:

• Deaths by drug poisoning are most prevalent among those aged 40–49, with increasing rates in the 50–69 and even 70+ age brackets.
• Opioids alone accounted for 53% of drug poisoning deaths in England and Wales in 2017.
• The average age of suicide rose from 22 in 1993 to 49 in 2017, reflecting a generational shift.

These trends highlight a grim reality for long-term drug users, many of whom began their habits in the 1980s and 1990s. Now, as their bodies age, decades of substance use take a greater toll, leading to life-threatening health crises.

Social and Economic Pressures

Drug-induced violence and premature death are highest in deprived communities, where generational poverty, unemployment, and social instability are common. Suicide rates are nearly four times higher among the long-term unemployed, doubling in deprived areas compared to affluent ones. Financial hardship, isolation, and mental illness all fuel this cycle.

Cocaine and Cannabis Psychosis Destroying Middle-Aged and Middle-Class Families

While much of the media spotlight rests on young people, it is actually older adults–particularly those aged 50 and up–who are most at risk of death from drug misuse. The number of cocaine deaths among the over-50s has soared, with their ageing bodies less able to metabolise the toxins and handle the cardiac effects.

Middle-Class Mums and the Hidden Face of Addiction

Recent reports and first-person accounts expose a growing problem among “ordinary” families. One anonymous mother shared her spiral from Friday night wine to cocaine-fuelled weekends, using drugs to escape isolation and the relentless pressures of parenthood. Lockdown only fuelled this behaviour, turning casual users into regulars. She recalls, “There were times I neglected my children during binges and felt deep shame when my eldest saw white powder on my nose.” Her 17-year marriage crumbled under the weight of addiction, leading her and her ex-husband into rehab.

The hidden addiction thrives among circles that appear stable and successful on the surface. Tragedy often strikes before anyone notices these families quietly being torn apart.

High-Profile Tragedies Highlight the Risks

From mothers caught drug-driving on the school run, to celebrities crashing while high, the signs are everywhere. The ONS’s Dr Campbell warns that even as Britain debates drug policy, many underestimate their risk, chasing the feeling of youth while their bodies and minds become more vulnerable to catastrophe.

Cocaine

Cocaine is now the UK’s second-most used drug after cannabis, and its dangers increase with age. Its cardiac toxicity can provoke heart attacks, strokes, dangerous arrhythmias, and even sudden death, especially for users with underlying health issues.

“What happens when you take cocaine is that you’re stimulating the body’s flight and fight response, and the heart responds appropriately by speeding up. In the older population, you’re often dealing with a patient who has other underlying medical problems—which makes treating them a lot less straightforward. They may be on blood pressure tablets, for example, or they might have had a stroke in the past.”  says Dr Farhan Shahid, a consultant interventional cardiologist at The Harborne Hospital, part of HCA Healthcare UK.

Long-term cocaine use brings with it a whole suite of potential health problems. It can increase an individual’s chances of suffering an aneurysm, because constricting the blood vessels over a long period may reduce the amount of oxygen the brain receives. It can raise the risk of strokes and lead to impaired cognitive function.

Shahid confirms that he frequently treats patients who display the chronic effects of taking cocaine: “It might, for example, be a 56-year-old who has high blood pressure as a background, regardless of the misuse. Taking cocaine on top of that will send their blood pressure off the chart, so to speak.

Over time, they become resistant to medication, and they may require admission into hospital and intravenous medication to bring their blood pressure down. Cocaine causes a compromise in the demand and supply of the heart muscle: it causes a constriction of the arteries and a state where the blood is thicker and has a greater predisposition to clot.”

Cocaine-induced paranoid states get worse as you get older,” says Dr. Campbell. “I had a patient who got together with friends to relive old times. They went away for the weekend, took cocaine, and as a result, he had a huge depressive crisis. He went back to the hotel and attempted suicide. Fortunately, he didn’t succeed.”

Cannabis

• Cannabis-induced psychosis is not a myth. The case of Kara Alexander is the starkest warning.
• Marijuana usage: Up from 0.4% to 2.9% in over-65s between 2007 and 2016. While some take it for pain, there are real risks like memory impairment, respiratory issues, and negative interactions with other drugs.
• Chronic, heavy use is linked to depression, impaired memory, and increased risk of respiratory and cardiovascular issues.
• Older users face heightened risks, particularly when combining with other substances.

Other Drugs

• Ecstasy depletes serotonin, leading to depression and anxiety.
• Psilocybin/magic mushrooms can trigger panic attacks and worsen mental illnesses.

While cocaine and cannabis misuse devastate families, the hidden dangers of prescription drug misuse among older adults represent another alarming facet of this crisis.

Prescription Drugs, and the Hidden Dangers for Older Adults

Substance use among older people often hides behind the image of prescription medication. The statistics are sobering:

• Almost 1 million adults aged 65+ lived with a substance use disorder (SUD) in 2018.
• Between 2000 and 2012, the share of older adults at treatment facilities doubled.
• Over 80% of adults aged 57–85 take at least one prescription drug every day.
• Nearly half use more than five medications or supplements each day.

Polypharmacy (taking multiple drugs) increases the risk of dangerous drug-drug interactions. One in 25 older adults faces major medical risks from medication interactions alone.

The Escalating Opioid Crisis

Opioid use deserves special attention:

• 4–9% of over-65s use prescription opioids for pain.
• Opioid prescriptions for older adults rose ninefold from 1995 to 2010.
• From 2013 to 2015, those over 65 seeking treatment for opioid use disorder increased by 54%.
• Heroin use among this group more than doubled in the same period, typically starting as misuse of prescribed opioids.

Nicotine & Alcohol

• Nicotine: 8% of people over 65 still smoke, contributing to a staggering 300,000 smoking-related deaths annually. However, quitting smoking after age 65 can extend life by 2–3 years.
• Alcohol: 65% of elders report high-risk drinking. Over 10% report binge drinking. Between 2001 and 2013, alcohol use disorder in over-65s more than doubled (up 107%).

Ketamine as Therapy for Depression: Caution Is Still Needed

Ketamine, sometimes used “off-label” for depression, is now appearing in clinics. But even medically supervised ketamine brings serious risks:

Short-Term Side Effects

• Dissociation and “out-of-body” experiences
• Vivid dreams, hallucinations, anxiety, panic
• Dizziness, nausea, vomiting, headaches

Long-Term and Rare Risks

• Dependence and tolerance with frequent use
• Rare, but possible, bladder damage and liver issues
• Cognitive impairment detected in recreational, high-dose users
• Mania, rare personality changes, tinnitus, and unknown long-term effects

Ketamine is not licensed for depression in most countries, and its risks require careful medical monitoring.

Aging slows metabolism, intensifying the effects of any drug. Chronic illness, slower recovery, and cognitive decline all compound these dangers. Older adults are also at higher risk for falls and crashes, and combining substances only increases the threat.

The Effects of Substance Misuse on Brain and Health Health

Alcohol and the Brain

Alcohol has drastic effects on the brain:

• Changes brain chemistry, dampening judgement and increasing impulsivity
• Heavy use over time raises risk of dementia, cognitive and memory decline
• Impairs the hippocampus (memory) and cerebellum (coordination)
• Damages the frontal lobes, affecting emotional regulation and leading to anxiety and depression

Chronic heavy drinking causes serious, long-lasting neurological problems and increases risk of accidents or violence.

Smoking, Drugs and Heart Health

• Smoking raises blood pressure and damages blood vessels, increasing risk of hypertension and strokes. It is also a trigger for heart arrhythmias, including atrial fibrillation (AFib).
• Alcohol bingeing and daily use without breaks substantially increase AFib risk and trigger both ischaemic and haemorrhagic strokes.
• Recreational drugs can disrupt the heart’s electrical system, increasing likelihood of life-threatening irregular rhythms or cardiovascular events.

It’s also worth noting that chronic cocaine use is linked with mental health issues like anxiety, panic attacks, and psychosis. Even a one-off line at a party can cause an individual to behave erratically and recklessly, leading to accident and injury.

Given the profound impact of substance use on brain health, it is crucial to prioritize prevention and awareness to mitigate these risks.

Prevention, Vigilance, and The Importance of Awareness

The cumulative evidence is stark. Substance abuse in older adults—from microdosing psychedelics, to increased opioid prescriptions, ketamine therapy, persistent smoking, cannabis, and problematic drinking—is growing. Yet, misdiagnosis is common, as symptoms can mimic normal ageing or existing health conditions. Treatment is effective but often missed due to lack of specialist care and poor screening.

Older individuals “playing Russian Roulette” with substances don’t just risk their own lives. They can set off spirals of harm—violence, self-injury, and severe health crises—that ripple throughout families and communities. Social deprivation only amplifies the risks.

There is no safe return to “how things used to be.” The ageing body is vulnerable—to violence, to disease, and to tragedy.

How to Counteract the Damage of Cocaine

“The simple answer is—stop,” says Campbell. “If you’ve taken cocaine and you’ve experienced palpitations, for example, that’s a serious red flag. A user needs to get themselves checked out. If you’re worried, talk to your doctor and be honest about it. Your GP can perform an ECG and arrange a full cardio workup.”

Anyone concerned should also take encouragement from the fact that it’s never too late to take a positive step. “With the right treatment and the cessation of the misuse, you can reverse the effects of cocaine misuse,” says Shahid. “Cocaine drives up blood pressure, so if you stop the cocaine use, you can reduce that blood pressure change, and—with the correct medications in the background—bring it down to safe levels.”

Of course, not everyone can afford to seek treatment at Priory, but as a first port of call, Campbell advises contacting Cocaine Anonymous, which he says is “free and widespread, and staffed by people who really know what they’re talking about.”

“This phenomenon is certainly a matter for concern,” he says on a final note, “and it’s on the increase, as the generation comes through that were partying in 1999. Could it get worse? I think it will, because people are reluctant to seek help. Unfortunately, they have no idea how much of a risk they’re taking.”

Do We Truly Understand the Cost of “Liberty”?

Why do we ignore these consequences in society’s fierce debate over personal freedom? Are the lives of Elijah and Marley not enough to force a rethink on the risks? The right to use drugs cannot outweigh the right of children to be safe, or families to stay whole. The cost is simply too high.

Protecting Lives and Futures: The Urgent Need for Awareness and Action

Substance use in later years is never just a harmless indulgence or a trip down memory lane. For many over the age of 40, it’s a gamble with devastating stakes. The ageing body is more vulnerable, and what may have seemed low-risk in youth now carries life-threatening consequences. Every line of cocaine, every drink abused, every pill misused magnifies the risks—to health, relationships, and entire families.

But this isn’t just about statistics or health warnings; it’s about lives. It’s about parents and friends standing helpless as someone they love spirals into crisis. It’s about children forced to pick up the pieces left behind by addiction’s relentless grip.

We must open our eyes to these risks, not just for ourselves but for those we care about. Awareness isn’t optional; it’s the first line of defense. Education isn’t a luxury; it’s a necessity to empower people to make better choices. And early intervention? It could mean the difference between a life saved and a family torn apart.

The stakes are painfully high. But we have the power to change this narrative. By staying informed and being there for those at risk, we can stop crises before they start. It’s never too late to protect health, relationships, and futures that might otherwise be lost. Because every life, at every age, is worth safeguarding.

Source:

Kara Alexander jailed for life for drowning sons in London

Telegraph – What drugs do to your body in middle-age

Ons.Gov.UK – Deaths related to drug poisoning in England and Wales: 2023 registrations

Ons.Gov.UK – Middle-aged generation most likely to die by suicide and drug poisoning

Telegraph – The rise of drug-taking middle-class mums

Ons.UK.Gov – Drug misuse in England and Wales: year ending March

Telegraph – The £8bn boom in magic mushrooms that’s sweeping Britain

SubstTance Use Tin Older Adults DrugFacts

Ketamine

Telelegraph – What is resting heart rate and why is it important for your health?

Telegraph – Atrial fibrillation: the heart health timebomb ticking away