Half of ketamine samples tested by Manchester Metropolitan University’s GM TRENDS drug monitoring system contained xylazine and medetomidine, posing ‘a significant health risk’.
The average ketamine purity per gram ranged from less than 50 per cent to 99 per cent, the researchers say, with an average of 74 per cent. Drug trends were identified for 44 substances, alongside online surveys of more than 200 drug and alcohol workers, homeless services, A&E nurses and consultants across Greater Manchester, and more than 800 13-25-year-olds.
Almost half of professionals identified an increase in ketamine use in the region, while nearly 40 per cent also identified an increase in the use of THC vapes. A quarter of young people reported using THC vapes to self-medicate for anxiety issues, much of them easily sourced via social media. The report also includes a street drug survey, with 19 per cent of professionals reporting declining heroin use as a result of poor quality, coupled with increasing use of crack, prescription drugs and spice.
Ketamine seizures at the UK border in the first quarter of this year were more than 40 per cent higher than the corresponding period in 2025 and the highest quarterly total for 15 years, while the most recent wastewater analysis by the Home Office estimated ketamine consumption in England last year at more than 30,000kg – with a market value of just under £1bn. Deaths involving the drug have increased 20-fold in just over a decade, many of them now occurring in ‘complex polydrug settings’.
‘The continued rise in ketamine use by young people and increased crack cocaine use highlights the need for services to adapt and reassess their current treatment offer,’ said professor of criminology and social policy at Manchester Metropolitan University, Rob Ralphs. ‘We’ve found young people are using ketamine to self-medicate their mental health which illustrates the necessity to provide services that offer support that addresses both mental health and substance use needs.’
‘The GM TRENDS research gives us vital, real-time insight into the changing nature of drug use across Greater Manchester,’ added Bury Council’s director of public health, Jon Hobday. ‘That insight is important because it helps us understand not only what’s happening on our streets and communities, but why it’s happening, who is most at risk, and how public services can respond more effectively. That local intelligence has the potential to help us as a city region target prevention more effectively and reduce harm among those who are most vulnerable to drug use.’
GM TRENDS findings available here