Several years ago, Mattea Kramer, an Amherst writer and researcher who’s studied and written about the federal budget as well as drug policies at state and federal levels, spent time interviewing a number of women in the Greenfield jail who were part of a recovery program for substance use.

Hearing their stories, and contemplating the wreckage that the opioid crisis had created in the lives of many people in the area, Kramer began thinking: Is there another way to tell this story, one that could bring better understanding of how people fall prey to addiction and how society often stigmatizes those who do?

That’s the thrust behind Mattea’s debut novel, “The Untended,” which draws on varied Valley landmarks and settings to create a portrait of a number of people caught up in the world of drugs and addiction. Their day-to-day lives, which already have their share of struggle – from underemployment, loneliness, troubled childhoods and more – become that much more difficult.

At the center of the novel is Casch Abbey, a 29-year-old mother of two young children who’s just barely getting by working as a waitress. She’s also about to get a visit from the state’s Department of Children and Families, possibly because her ex is messing with her and trying to paint her as a neglectful mother.

Much of the story is set in the fictitious town of Greenfield, Vermont, a place that doubles for Greenfield, Massachusetts, where Kramer grew up.

But Casch has spirit and imagines a better life for herself and her kids. She wants to go to nursing school, and early in the book she meets a potential love interest, Topher, an Army veteran who seems like a stand-up guy when he comes into her restaurant; she serves him and the two get to chatting.

Topher is a good guy, although he has own baggage. His service in Afghanistan has left him somewhat withdrawn, very disillusioned about politics and the way war makes victims of innocent civilians. “You have to kill in the name of good,” he says to Casch. “That’s lie number one.”

Topher also makes a living by secretly growing pot in a remote section of Vermont’s Green Mountains. And as much as she’s attracted to him, and as much as he appears to care for her – they also have a mutual love of nature — Casch wonders what kind of future they might have together. What is she supposed to tell her children, 11-year-old Molly and 7-year-old Dean, about Topher’s job?

Before long, these issues start becoming secondary. Casch is injured in a freak accident when a driver runs over her foot in a parking lot. She’s in serious pain, and a doctor writes her a prescription for a heavy-duty painkiller.

Yet when the drug is then taken off the market because of growing complaints that it’s highly addictive (shades of OxyContin), Casch finds she can’t get by without some kind of lift, leading her into darker corners of Greenfield in search of something that will make her feel better.

Understanding addiction

In an email, Kramer said she thought writing a novel could “bring empathy to our understanding of addiction” in ways that news articles don’t, in part because “fiction can reveal interior experience.”

An Amherst College graduate (class of 2007) who also has a master’s in public policy, Kramer has written about addiction and the pharmaceutical industry for publications such as Salon and The Nation. As well, she’s a former researcher and writer for National Priorities Project, the Northampton nonprofit that breaks down the complexities of the federal budget for organizations and individuals.

Kramer says she initially approached the novel in some ways like a nonfiction piece, “with lots of research and interviews. Eventually, of course, with fiction you have to get out into the terrain of imagination, which is really challenging, and in that area I have the characters to thank, because they led me where they were already going.”

Not that it was easy. She began “The Untended,” published by She Writes Press, a hybrid press that works exclusively with women writers, in 2017, and she says the novel went through many different drafts and benefited from readings and suggestions by a host of other writers and researchers.

It’s uneven in places, and a plot line that suggests a dark past between Casch and her stepfather, Russ, does not seem fully developed. But “The Untended” also has a stripped-down, visceral quality of writing that makes the story readily accessible, bringing real empathy to Casch’s character in particular and also painting an engaging portrait of Topher, who like Casch struggled with a challenging upbringing and now seeks a simpler life.

It’s not giving too much away to say that Casch will find herself spiraling down a bigger and bigger hole as she turns to harder substances than prescription painkillers to deal with her addiction. She begins shoplifting, takes personal items to pawn shops to earn a little more cash, and then shuts Topher out when he inadvertently discovers she’s using.

She’s well aware that she’s damaging herself and letting her children down, and she tries to fight her addiction, her self-destructive behavior, and her increasing isolation – as well as the feelings of self-loathing all of this engenders.

“You are trash,” she says to herself at one point. “You are a piece of trash.”

Kramer says part of her motive in writing “The Untended” was to explore how society often stigmatizes addiction, even as cannabis is increasingly legalized, alcohol is celebrated in advertisements, and recreational drug use takes place in certain circles. She’s a recreational drug user herself, she says, though she’s never used opioids or experienced addiction.

But, she notes, there’s a double standard between “affluent people using drugs versus people who have no money using drugs: the former are generally considered fine (even cool), while the latter are stigmatized.

“I have witnessed people enjoying their favorite drug while judging other (poorer) people for enjoying their favorite drug,” Kramer added. “And I wanted to write about a deeply human reason why many people use substances: to ease emotional pain.”

“The Untended” also explores the grim story (via a fictitious name) of Purdue Pharma, the Connecticut-based company that manufactured OxyContin and, with its owners, the Sackler family, has faced multiple lawsuits over the past 20-plus years from people who lost family members to OxyContin addiction.

A secondary character in the novel, Ronnie, loses his son to prescription drug abuse, and he turns to his friend and coworker, Russ (Casch’s stepfather), for help, such as by bringing him to meetings of a local support group for families of people affected by addiction. That in turn begins to open Russ’ eyes to things in his own background that he’s buried for years.

All in all, “The Untended” offers a good overview of the conflicting messages society sends about addiction, as well as how addiction, isolation and lack of opportunity can destroy people’s lives.

“The judgment and stigma toward specific drugs and drug use morphs over time as our culture changes,” Kramer says, “all the while harming people, especially people without economic power.”

Steve Pfarrer, now retired, is a former arts and features reporter for the Gazette.