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Ciara's killers in list of importance:
1. Noah
2. Ciara.
3. Jay.
4. JT
Noah introduced her to heroin and benzos, and taught her how to buy drugs online at 14. She went from a MLP:FiM obsessed kid to heroin between 13-14. She was always going to be weird, and had dark triad tendencies, but this gave her a bad opioid addiction. Strangely, Ciara never mentioned Noah again, and given the amount of opioid deaths, it's not even clear if he's alive or not.
Then Ciara-san herself. She was fine with her lifestyle, and scamming, drugs, and sex, seemed to be her only life goals.
Jay was a sketchy guy who went into a devil's arrangement with Ciara. By giving her a place outside of her parents home, it allowed Ciara free reign to scam and do hard drugs, and her condition continued to deteriorate. He knew if he was ever harsh with her, she'd just leave him for another guy to mooch from.
Finally there's JT, who agreed to buy drugs and party with her in that hotel room. His role is more of naivity and negligence, where he gave her Narcan to bring her back once, but then failed to deliver her to a hospital. He likely felt he might get into legal trouble for this when you really can't. If he called a cab, then drove to the emergency and said she OD'd, he administered narcan, can you look after her for the night and check up (and this is all factual), Ciara would have likely survived.
In his write-up, JT says they went to bed. I suspect there was yet more drug taking and Ciara OD'd again during the night. He awoke to her dead.