Emerging trends for substance use in Greater Manchester highlighted in new report

New findings from the second GM TRENDS report have revealed the latest trends and patterns for substance use across Greater Manchester. 

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 aims to identify changing patterns of drug use across all ten Greater Manchester local authorities, with the latest trends covering research conducted in 2022.

GM TRENDS provides the region with the most comprehensive local drug intelligence function in the country with the full report identifying key drug trends for 44 substances, alongside two trend focuses highlighted by the initial stages of research.

The findings will help inform the Greater Manchester Local Drugs Information System, provide recommendations to local authorities on the development and delivery of services for substance users, and support with the development of harm reduction policies and initiatives.

Key highlights of the findings include an increase in the use of prescription drugs, typically purchased from the Bury New Road area of Cheetham Hill. Both benzodiazepines (e.g., diazepam) and gabapentinoids (pregabalin and gabapentin) featured in the top three substances, alongside alcohol, that professionals reported seeing an increase in use of.

Findings indicate the illicit use of pregabalin is largely concentrated in the homeless and street-based populations and is becoming increasingly popular with heroin and crack cocaine users.

The popularity of prescription drugs such as diazepam and pregabalin that we highlighted last year has continued to be reported. Monitoring the impact of Operation Vulcan on the availability, content and use of these substances will be a priority this year.

The report’s adult trend focus exploring the use of ‘chemsex’ - the use of specific substances with sex to facilitate and enhance both experiences - by men-who-have-sex-with-men revealed an increase in the local availability of crystal methamphetamine - one of the substances commonly associated with chemsex – along with a reduction in price, and a change in demographics of users.

Meanwhile, the young person trend focus explored the increase in young people using nitrous oxide – commonly known as laughing gas - along with a shift in preference for using larger cannisters over the small silver ones due to cost, ease of use and a perception that they are safer to use. Among the 44 substances respondents were asked about, nitrous oxide had the fourth highest reported increase in use, following the top three of benzodiazepines, alcohol, and gabapentinoids.

Researchers analysed existing data, conducted online surveys of 236 Greater Manchester professionals, 386 young people who are in contact with drug treatment or family services, 173 people who use drugs (PWUD), alongside interviews with 80 key professional informants, and 54 interviews with PWUD (young people and adults).

This was accompanied by the testing of 217 drug samples by the Manchester Drug Analysis and Knowledge Exchange (MANDRAKE), a drugs testing research project based at Manchester Met developed with Greater Manchester Police to test non-evidential drug samples, along with samples submitted by other external agencies.   

Key testing results revealed increases in the purity of key substances including heroin and cocaine, while cannabis that is being sold as ‘Cali weed’ was found to contain high levels (around 30%) of THC, the main psychoactive compound in cannabis.

Dr Oliver Sutcliffe, Director of MANDRAKE, commented: “The chemical analysis of samples, within this cycle, has indicated higher purity heroin, cocaine and MDMA circulating since 2021/22. The increase in the prevalence of high THC content (ca. 30% w/w) cannabis, colloquially known as “Cali Weed”, is also significant. Increased heroin purity, may in part explain the observed shift away from synthetic cannabinoids (Spice) in our homeless and adult treatment populations.”

Professor Rob Ralphs, Professor of Criminology and Social Policy, commented: “The popularity of prescription drugs such as diazepam and pregabalin that we highlighted last year has continued to be reported. Monitoring the impact of Operation Vulcan on the availability, content and use of these substances will be a priority this year.

“The increased availability and use of crystal meth is a concern, and we aim to closely monitor this drug for signs of emerging use beyond the chemsex scene. This year’s recently launched young person’s survey for 13- to 21-year-olds is particularly interested in capturing information on the use of nicotine and THC/cannabis vapes by young people.” 

David Regan, Greater Manchester Drug and Alcohol Transformation Board co-chair, said: “The use of drugs is ever changing with new and different substances constantly entering the illegal market. If we are to do the most effective job possible in keeping people safe and reducing drug related harms, we have to know what is out there.

“That is what makes this a really important piece of research. We can use these findings to work with local authorities and Greater Manchester Police in a targeted way to shape prevention and support services across the city-region.”

The use of drugs is ever changing with new and different substances constantly entering the illegal market. If we are to do the most effective job possible in keeping people safe and reducing drug related harms, we have to know what is out there.

Findings revealed the variable content of illicit prescription tablets from the Bury New Road area raised concerns around the risk of overdose.

Recommendations include a review of existing practices; and close monitoring of the impact of ‘Operation Vulcan’ a two year, GMP led, multi-agency operation to address this illicit market that began in November 2022; alongside the development of harm reduction policies advising young people and adults on the risks of benzodiazepines.

The report’s ‘trend focus’ on adult use of chemsex has highlighted the need to monitor the availability and use of crystal methamphetamine in the next GM TRENDS report covering research conducted in 2023, along with ensuring frontline medical and treatment services are prepared and trained in responding to its use.

Following the trend focus on young people’s use of nitrous oxide, recommendations have been made for the development of clear harm reduction advice to help raise awareness and monitoring of market changes in light of the forthcoming legislative changes which will bring nitrous oxide under the control of the Misuse of Drugs Act.

The full GM TRENDS report and trends focus reports can be viewed on the GM TRENDS website.