Half of ketamine samples tested contained other harmful substances posing health risk, new report reveals
Rise in use of ketamine and THC vapes among young people also highlighted in report on emerging drug trends in Greater Manchester
Testing of ketamine samples from across Greater Manchester has found a large variation of purity with half of samples containing harmful substances posing health risks, according to the latest review of drug use across the region.
Commissioned by Greater Manchester Combined Authority (GMCA) and led by researchers from Manchester Metropolitan University, GM TRENDS is an emergent drug trends monitoring system that identifies changing patterns of drug use across all ten Greater Manchester local authorities.
Findings inform harm reduction policies including the Greater Manchester Local Drugs Information System and assist with the development and delivery of services for substance users.
The full report identifies key drug trends for 44 substances, alongside an in-depth street drug survey which was introduced for the first time this year, covering research conducted between April 2025 and January 2026.
Researchers analysed data, conducted online surveys of 212 Greater Manchester professionals including drug and alcohol social workers; adult and young people substance use and homeless services; pharmacists; and hospital A&E nurses and consultants - and 817 young people aged 13 to 25 through the North West Young Person, Children and Families Professional Network, alongside interviews with 85 key professional informants.
This was accompanied by the testing of 217 drug samples by the MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), an award-winning drug-testing research project based at Manchester Met developed with Greater Manchester Police to test non-evidential drug samples – of concern but not leading to prosecution – and samples submitted from other external agencies.
Testing found ketamine purity varied widely – ranging from 48–99% purity per gram (average 74%) - and of the 32 samples tested, half (50%) contained the potent veterinary tranquiliser xylazine and medetomidine which poses a significant health risk.
Almost half (47%) of professionals reported increased ketamine use among adults and young people across most areas of Greater Manchester, with many using it to self-medicate for mental health issues.
The report also revealed continued concerns from professionals around the sharp increase in use of harmful THC vapes - vapes that contain the main psychoactive component of cannabis – in the last year, especially among young people.
Two-fifths (38%) of professionals reported increased THC vapes use, with almost one in six (16%) young people using them in the past year, particularly under 18s.
Almost a quarter (24%) of young people reported using THC vapes to self-medicate for anxiety with professionals raising concerns about easy access through social media where substances can be found quickly and at a low price.
The Street Drug Survey interviewed 48 people who used key ‘street drugs’ - heroin, crack cocaine, spice, benzodiazepines, or pregabalin - alongside 212 professionals who were surveyed and 85 interviewed.
Findings revealed growing concerns about poor quality heroin and suspected synthetic opioids in circulation, with around 70% of samples containing less than 5% of heroin. As a result, some users reported turning to alternatives including crack cocaine, prescription drugs and spice.
Almost a fifth (19%) of professionals reported a decline in heroin use due to poor quality while the use of crack cocaine and availability was reported to be increasing.
Rob Ralphs, Professor of Criminology and Social Policy at Manchester Met, said: “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. 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.”
Dr Oliver Sutcliffe, Director of MANDRAKE, said: “During the last testing period we’ve seen significant changes in the purity and content of drugs in circulation, including concerns around synthetic opiates such as nitazenes and fentanyl. Most notably, we found a rise in ketamine use and contamination with powerful veterinary tranquilizers which have the potential to cause significant harm, reinforcing the importance of continued work with partners to safeguard our communities.”
Jon Hobday, Director of Public Health at Bury Council and Co-Chair of the GM Drug and Alcohol Board said:“The GM TRENDS research gives us vital, real-time insight into the changing nature of drug use across Greater Manchester. 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.”
Findings were shared at a stakeholder event at Manchester Met opened by Kate Green, Deputy Mayor of Greater Manchester, and attended by health, policing and treatment partners across Greater Manchester who took part in workshops to help inform the recommendations.
Key recommendations include improved support, targeted education and awareness for young people using ketamine to address major gaps in age-appropriate services, stronger awareness around the risks of THC vapes alongside action to tackle the sale of high-strength devices, and expanded harm reduction and treatment services to address concerns around poor quality heroin.
The full GM TRENDS reports can be viewed on the GM TRENDS website.