'Ireland's drugs problem is worse than ever' - Woman who began abusing drugs aged 11, and nearly lost her arms due to her habit
When Rachael Keogh showed the sores on her arms and pleaded for help because they were at risk of amputation, there were just 27 detox inpatient beds available in Ireland.
In 2006, the shocking image of Rachael, a young woman at risk of death from chronic drug abuse, subsequently lead to a national debate about drug services.
However, 13 years later and there are just 19 detox inpatient beds.
This lack of beds exists despite figures released this week by the Drug Treatment Report from the Health Research Board showing that there were over 8,900 cases of problem drug use in 2017.
“The drug problem has become a lot worse, but very little has changed in terms of the supports available. When I made the public appeal, it was because I couldn’t get a detox bed. There were 27 impatient detox beds and now there are 19,” says Rachael.
“If you are taking heroin and crack or if you are a polydrug user – your chances of accessing a detox bed are very slim.
“The criteria you have to meet is near impossible. You have to be off all drugs except methadone before you can get a bed, which I find backwards. If you were off all drugs, then the need for an in-patient bed is less urgent. This is one of the biggest gaps in drugs services.”
On May 1, 2009, the Sunday World exclusively published a series of extracts from Rachael’s autobiography, Dying to Survive. The book told the harrowing story of how an angelic-looking teenager from Ballymun, north Dublin, became chronically addicted to heroin.
She described how she began abusing drugs at the age of 11 and fuelled her habit through petty crime. Shockingly, she was locked up in Mountjoy Prison at the age of 15.
Now, on the 10th anniversary of its publication, the book has been updated and re-released.
Speaking to the Sunday World, Rachael says she tried to get help as a teenage addict, but there was none available.
“When I was 15 my family brought me to a well-known treatment centre. I was injecting heroin every day at that point, I was properly strung out – I had a habit.
“But they turned around to myself and my family and said that I wasn’t old enough to be recognised by the State as a drug user.
“I had started smoking heroin when I was 13, but the wheels really came off when I started injecting, my whole personality changed. My tolerance got higher, I got less from the drug. For whatever reason, when I started smoking hash and drinking, that was the end for me.”
Rachael believes her descent into addiction was more rapid than the other people around her.
“I was painfully shy. I was 11 and I was very awkward and self-conscious. Smoking hash helped me to be freer in myself. Hash led to ecstasy – it all happened really quickly.
“I was one of the quieter people, I was hanging around with people from the blocks in Ballymun, and I wrote about how I thought most of them were gurriers.
“But I crossed some invisible line and overtook them in terms of drug use once I took ecstasy. All I could think about was taking the drug. I was totally preoccupied, I couldn’t think of anything else, I stopped concentrating in school.
“I remember seeing someone going past in a fancy car and saying to one of my friends: ‘That will be me in a few years.’ He said: ‘No it won’t, you’ll be more like them junkies hanging around the shopping centre.’ I started laughing – but he didn’t.”
When Rachael was 17, her family arranged to get her a bed in a detox unit outside the country.
Although she got clean in the unit, she now believes she had not fully comprehended the severity of her addiction.
“I saw the blocks in Ballymun from the plane on the way home and all I could think about was drugs again. The blocks and the drugs were a package deal for me, a mentality.
“I just thought I will get a bit of hash and I will be alright. I had very plausible narratives that ran alongside my drug use. I thought: ‘If I wanted to stop, I could – I just don’t want to yet.’ Within a few weeks I was back using heroin, and that’s when I ended up in Mountjoy.
“I was funding my habit through petty crime, shoplifting. I still to this day don’t understand how I wasn’t old enough to be recognised as a drug addict in need of help, but yet I was old enough to be incarcerated for petty, drug-related crime.”
When Rachael first went public looking for help in 2006, she said she was very anxious to take personal responsibility for the chaos caused in her life, but with a number of years clean time behind her, she now views her addiction differently.
“I take full responsibility for my own actions, but as a 15-year-old I should never have been put in an adult jail. I should have been treated as a sick child.
“We need to recognise that drug addiction disproportionately affects working-class communities. The government need to take responsibility for the structural inequality.
“If you are growing up in an impoverished area you are very susceptible to alcohol and drugs and with that comes violence, trauma and crime. Obviously, there are lots of people from working-class areas who never experience that, but the statistics show addictions are more prevalent in working-class areas.
“Drug users who have resources can slip under the radar and go unnoticed with their drug use. They can roll into private hospitals twice a year or pay €17,000 for a spiritual experience and rarely have to rob to feed their habit. People who live hand to mouth cannot afford that level of care. We are essentially criminalising the poor – not drug users.”
Since getting clean, Rachael has become a prominent campaigner for the decriminalisation of drugs in Ireland. She also recently appeared in the Ana Liffey Drug Project’s as part of their Safer From Harm campaign.
“Part of the reason I am relaunching the book is that I am very conscious of the loss people have suffered and how sensitive an issue it is,” she says.
“I have been able to be involved in the push to decriminalise drug use and it is something I am really passionate about.”
l Dying to Survive is available from bookstores at a cost of €9.99