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An important caveat though:
"The authors explain that one of the limitations of this study is that drug harms are functions of their availability and legal status in the UK, and so other cultures' control systems could yield different rankings."
Cocaine is still illegal, and by extension less available. I'm no expert, but I have to imagine that is affecting the rankings here significantly.
Yeah, but it's be hard to tell whether legalization would lower the rating or raise it as there's a lot of confounding factors. For example overdoses and direct mortality would probably go down since people could dose properly instead of guessing. Crime and financial issues could also go down with an open market making it cheaper and safer.
On the other hand larger scale societal problems could be revealed by mass availability. Also more health problems from chronic use could be revealed once legalization allows for more and larger studies. Or maybe current studies on it are overestimating the harms because current illicit cocaine users tend to be unhealthy for other reasons and your average person will have less problems with cocaine use.
Either way I think it'd be hard to argue cocaine isn't at least on the same level as alcohol and should be legal. Contrary to mainstream discourse that views it as some evil powder that will make you addicted if you even look at it.
I'm generally in favor of legalization, but we should go into it with the best, most accurate information we have about the potential impacts so preparations and safety nets can be made in advance.