We are issuing this alert following new reports of ketamine contaminated with medetomidine in the North West. This includes several confirmed positive test-strip results and multiple laboratory detections in Manchester.
Medetomidine is a very strong veterinary sedative, far more potent and longer-lasting than xylazine. When mixed with ketamine, it can cause extreme sedation, breathing difficulties, and a much higher risk of overdose and death. People have reported unusually fast onset, bad taste, and unexpectedly heavy sedation.
Drug supplies across the UK are becoming increasingly unpredictable. Even if something looks like ketamine, you cannot be sure what is in it.
Photo of Contaminated Ketamine found in Manchester.
What we know
Recent testing in Manchester found:
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Medetomidine in multiple samples sold as ketamine
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Levels varied widely, including samples where medetomidine made up over half of the total content
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No visible differences between contaminated and uncontaminated samples
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Effects described as instant onset, very unpleasant taste, and far heavier sedation than usual
Medetomidine is now being detected across the UK in heroin, synthetic opioids, and other substances. Cases remain rare but are rising.
Risks
Medetomidine is 100 to 200 times more potent than xylazine.
It can cause:
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Extreme, long-lasting sedation
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Slow or shallow breathing
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Very slow heart rate
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Low blood pressure
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Dizziness, confusion, blurred vision
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High risk of losing consciousness
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Inability to respond or call for help
Mixed with ketamine, the sedating effects are much stronger and last longer. This increases the risk of overdose, accidents, injury, and vulnerability to harm.
Harm reduction advice
1. Drug supplies change, best test first
What you buy is not always what it’s sold as, and strength varies a lot.
Start with a small test dose first.
2. Do not use alone
Always try to use with people you trust. If something goes wrong, someone needs to spot the signs and call for help.
3. Look out for your mates
Signs of overdose include:
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Loss of consciousness
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Snoring, gurgling, or raspy breathing
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Very slow, shallow, or stopped breathing
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Blue or pale lips or fingertips
If in doubt, call 999 immediately.
4. Naloxone: get it, carry it, use it
Naloxone does not work on ketamine or medetomidine, but it does work if opioids are also involved.
As the drug supply is unpredictable, it is still vital to carry it.
If someone collapses, give naloxone and call an ambulance.
5. Recovery position saves lives
While waiting for help:
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Check they are breathing
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Clear their airway
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Put them in the recovery position
6. Consider drug treatment
Being in treatment reduces the risk of overdose and gives you access to ongoing health support.
Key reminder
You cannot tell by looking at ketamine whether it contains medetomidine. Even experienced users are at higher risk because this contaminant is extremely strong and long-acting.
Wirral Ways is exploring access to medetomidine test strips for local use and will update partners when available.
If you hear of contaminated drugs, bad reactions, or positive test strip results
Please report this to Wirral Ways as soon as possible so we can help keep people safe.
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