Young People Are Still Dying From Heroin

I met Kayleigh Jukes during the summer of 2014 while researching a story about ketamine use in the lively south-coast city of Brighton. Her friend, Nancy Lee, had died six months earlier aged only 23, after seven years of heavy ketamine use had corroded her body from the inside.

Kayleigh was petite and looked younger than her 21 years. In our conversations she was always kind, thoughtful and intelligent. She explained to me that she had been using ketamine since she was 15 and had already had a two bladder reconstruction operations after using multiple grams of super cheap ketamine every day shrivelled her bladder so much it was only capable of holding a shot glass worth of liquid. She told me she was angry that for the last year she had been trying to get help for her ketamine addiction, to no avail.

At the time, everyone hoped that Nancy's tragic death would shock her young, K-using friends in Brighton and Bristol into giving it up. Partly spurred on by a drought in ketamine supply over 2014 and 2015, some of them did.

However, last year I'd started to hear that the ketamine drought – in part prompted by a clampdown on the drug's illicit manufacture and distribution in India – had pushed some of the hardcore ketamine users onto heroin. Kayleigh was one of them.

In March her body, surrounded by drug paraphernalia, was found in a notorious drug den in Shanklin Road, Brighton. She had been dead for up to two days, her body abandoned by the flat's tenant, a man who had become her drug taking partner.

At her inquest at Brighton Coroners Court on Friday, 21st July, coroner Veronica Hamilton-Deeley recorded Kayleigh's death as fatal toxicity of heroin through misadventure, with self-neglect and extremely low body weight as contributing factors. She had been injecting heroin, alongside crack cocaine, into her groin.

Hamilton-Deeley told the inquest she was "distressed" when she heard about the death because she had met Kayleigh only a few months earlier, as a witness during the inquest into the death of one of Kayleigh's friends, Oscar Maskell. Maskell, 23, an inexperienced drug user, was with Kayleigh when he died of a heroin overdose last August. It was Kayleigh who called 999. "It's awful to be sitting in court to hear about another young person whose life has been lost," said Hamilton-Deeley.

In an era where heroin has such a bad image among young people, partly because of the "scarecrow factor" of older users being so visibly ravaged by the drug, very few go anywhere near it. The number of young people entering treatment for heroin has plummeted since the Trainspotting days of the 1990s and so have the number of deaths.

But Kayleigh and Oscar are not alone. They are part of a slowly rising tide of drug deaths, especially relating to heroin, in the last few years among people in their teens and twenties.

Between 2012 and 2015 the number of recorded drug related deaths of people under 30 rose from 259 to 346. Surprisingly in an era of new psychoactive substances, MDMA and cocaine, in which heroin is viewed as a throwback, the proportion of these deaths involving the drug is creeping up. In 2012 there were 95 recorded heroin related deaths of people under 30. By 2015 this had risen to 154. This upturn could in part be linked to increasing heroin purity since it hit rock bottom in 2010 and austerity-driven cuts to drug treatment services, but what is certain is that heroin is a drug that still has pulling power among young people.

According to evidence given at her inquest, Kayleigh had started using heroin by at least early 2016. She was treated at hospital for a suspected heroin overdose in April last year and briefly received treatment for heroin addiction at Pavilions, a substance misuse service, for two months before disappearing off their radar.

Two months before her death, Kayleigh had become dangerously underweight, with a BMI of 16.8. She constantly went missing: most people had no idea that she was staying at the flat in which she would die. She had been treated in hospital three times, for an abscess, a skin infection and hypothermia – all conditions associated with injecting heroin. She refused all help: from her mother and from the drug services that could have kept her alive.

"There was a lot of good about Kayleigh," said Detective Constable Marcus Roberts, who knew her from Oscar Maskell's inquest. "She had a moral compass about herself. She was addicted to drugs but still very much a human being inside and it was a pleasure to be with her."

Why are people in their teens and 20s turning to heroin? Some appear to be drawn in after initially becoming addicted to other substances and then switching. In February I reported how young homeless people in Newcastle and Belfast with Spice addictions had moved onto heroin because it eases withdrawal from Spice. For some, heroin has become the cheaper option after a small rise in the price of Spice since last year's blanket ban on all new psychoactive substances. I am told that heroin dealers in Liverpool have many young customers, although this is not yet reflected in the numbers of young people in the city receiving help for heroin addiction.

Those who knew Kayleigh said she moved from using ketamine with her friends to using heroin and crack cocaine because of the ketamine drought. The lack of ketamine meant it was increasingly poor quality and expensive and so, while some started using valium and alcohol, Kayleigh started using heroin and crack.

"I've known four people who have died of heroin overdoses since Christmas," says one of Kayleigh's friends, who wants to remain anonymous. "This is one of the problems Brighton is suffering from as a result of the last major K drought and the price hike that followed. I know a lot of K heads who turned to smack when they couldn't get K for so long."

Her friend believes Kayleigh's intensive use of ketamine and then heroin and crack was a symptom of her unhappiness. "She had depression. She had a lot of issues and I think they were getting on top of her. So she chose to play roulette, knowing one day the gun would go off. For me, it was like trying to stop a freight train, it was very upsetting to watch."

Heroin use and deaths from the drugs are far lower among young people than people in their 40s, 50 and 60s. Even though deaths of under-30s are climbing, evidence there is a resurgence in heroin use among young people is thin on the ground. Young heroin users are an elusive group. Like Kayleigh, young people are notoriously reluctant to engage with treatment services, so they do not figure in official statistics.

"There are concerning reports from various parts of the country that there is indeed a new generation of young heroin users, who often have little or no contact with services or older users," Michael Linnell, co-ordinator of UK DrugWatch tells me.

"Heroin was never going to go away, as it is used for a reason," says Linnell. "It is a very effective painkiller. It kills physical and emotional pain, which is often the reason it is used by the most vulnerable and troubled people in our society."

Kayleigh was using ketamine and later heroin in a destructive way for almost all of her adult life. Like her friend Nancy who the authorities failed to save, Kayleigh posed a very limited threat to wider society. They did not mug or burgle. Their destructive self abuse through drug addiction was not linked to wider crime. They were not priority cases for a government drug strategy that is firmly rooted and funded by its law and order arm, the Home Office. These girls were only a threat to themselves and perhaps this is why the rescue never came.

@narcomania