When middle-class or affluent people use drugs, it’s considered okay or even cool. But when poor people use drugs, it’s considered bad and dirty. I wanted to write about the humanity of drug use: the reality that a lot of people use drugs to help them deal with their lives.
Mattea Kramer – 15 May 2025
The Back Flap
Casch Abbey is a waitress, single mom, and recreational boxer who falls in love twice: first with a veteran who secretly grows pot on a rich man’s land in Vermont’s Green Mountains, and then with a painkiller that eases her long-buried pain.
After her foot is crushed under the wheel of a station wagon, Casch loses her waitressing gig and goes broke—and the meds for her foot are her only source of relief. But when the drug is recalled due to outcries of widespread addiction, Casch’s dependence imperils her already tenuous life, as cravings lead her into her small town’s simmering netherworld.
Intimate and exhilarating, The Untended will upend your every assumption about who is a hero and who is worthy of love.
About the book
What is the book about?
The Untended is about a single mom who gets addicted to painkillers—but really it’s about the utter humanity of drug use. Casch Abbey is a waitress, mother, and recreational boxer who falls in love twice: first with a veteran who secretly grows pot on a rich man’s land in Vermont’s Green Mountains, and then with a painkiller that eases her long-buried pain.
After her foot is crushed under the wheel of a station wagon, Casch loses her waitressing gig and goes broke—and the meds for her foot are her only source of relief. But when the drug is recalled due to outcries of widespread addiction, Casch’s dependence imperils her already tenuous life, as cravings lead her into her small town’s simmering netherworld.
When did you start writing the book?
I started writing The Untended in the fall of 2018. But I started researching the topic in 2017, and before I began writing the book, I first wrote a reported article about the opioid crisis in my hometown—Greenfield, Massachusetts—as a sort of test of concept.
How long did it take you to write it?
It took me a year to write the first draft. Then I continued to write and revise for several more years. In the spring of 2023 I finally saw what I needed to do in order to really finish it. That realization that came through an experiment in which I started writing the book as a screenplay. I did that in order to see the story with fresh eyes and essentially to learn what was missing. The experiment worked! I saw what I needed to do at the end of the book in order to make it a satisfying story for the reader, and that’s when I finally finished what was essentially the last major revision.
Where did you get the idea from?
The idea came both from the opioid crisis in my hometown and from my personal experiences with drugs. I noticed this huge hypocrisy in how our culture regards drug use: When middle-class or affluent people use drugs, it’s considered okay or even cool. But when poor people use drugs, it’s considered bad and dirty. I wanted to write about the humanity of drug use: the reality that a lot of people use drugs to help them deal with their lives.
Were there any parts of the book where you struggled?
Definitely. The most significant struggle was writing the protagonist so that readers could connect with her good qualities. Casch did not have an easy life, and by the time readers meet her she’s just days away from becoming addicted to the painkillers that are prescribed to her for a broken foot. So it was essential that the first few pages of the book give readers a chance to see her generosity, her devotion to her kids, her wit and smarts—because the story ahead has dark chapters.
What came easily?
I was surprised by what came easily. Casch’s love interest, a veteran of the Afghanistan war named Topher, was very accessible to me. There’s a chapter where Topher is out in a secret field taking care of his pot plants and thinking about his time in the war, and for reasons I will never understand, that chapter flowed easily from my fingertips onto the page, and required very few edits afterward.
Are your characters entirely fictitious or have you borrowed from real world people you know?
They’re fictitious. Although the original inspiration for both Casch and Topher were real people, they were not people I knew well. I knew just enough about them to experience inspiration, and then I had to imagine the rest.
We all know how important it is for writers to read. Are there any particular authors that have influenced how you write and, if so, how have they influenced you?
So many writers inspire me. I think the most important ways I’ve been influenced by other writers have to do with work ethic and confidence, in that order. I remember reading a profile of Jennifer Egan years ago in which she said she writes 30 drafts of every chapter. A Visit From the Goon Squad is such a masterpiece, and to me it just made sense: It takes thirty drafts to write something that good. A couple years after that, I heard Viet Than Nguyen speak at a literary festival where he described editing The Sympathizer backwards at the sentence level. Again, this just made sense to me—and I think Nguyen is perhaps the most brilliant writer writing in English today.
Do you have a target reader?
No.
About Writing
Do you have a writing process? If so can you please describe it?
My writing process was strongly influenced by the guidance in Julia Cameron’s The Artist’s Way. When I have an idea or I’m working to get something on the page, I ask questions: I literally write down a question in my notebook. Then I scrawl stream-of-conscious handwritten notes to explore potential answers—which is essentially what Julia Cameron calls morning pages. I’ve been writing morning pages in one form or another for more than a decade. I am continually amazed by how fruitful it is for me to write down a question to which I believe I don’t know the answer; so often, answers come flowing to me as soon as I’ve written the question. I strongly recommend The Artist’s Way.
Do you outline? If so, do you do so extensively or just chapter headings and a couple of sentences?
Yes, I outline. For the initial concept of The Untended I used an outlining process called the “Snowflake Method” that was created by software engineer-turned-writer Randy Ingermanson, in which I started with a one-sentence concept that I expanded methodically into chapter outlines and even a spreadsheet with a list of scenes. I found the Snowflake Method really helpful to get me started, and the spreadsheet was helpful through the entire process because it helped me keep track of everything. All that said, outlining becomes less important to me once I’m deep into the writing process—at which point “outlining” can be as loose as scribbling a couple notes of what I want to do before I do it.
Do you edit as you go or wait until you’ve finished?
I edit lightly as I go and then edit deeply when I’ve finished. And then I keep editing and then I get feedback from readers on what I’ve written, and then I edit again, and again. You get the idea.
Do you listen to music while you write? If yes, what gets the fingers tapping?
Yes. One of my favorite jams to write to is Don’t Want This Groove to Ever End by LTJ Experience.
About Publishing
Did you submit your work to Agents?
Yes. An earlier version of this book was represented by an agent and went out on submission in 2020. It didn’t sell, though, and I think at that time the manuscript genuinely wasn’t ready; I wrote several more drafts over several years after that. The way the traditional publishing industry works, though, is that once something has been unsuccessful on submission, it is very hard to convince an agent to give it another shot. That was a huge disappointment for me at the time. Looking back, I see that the process unfolded perfectly, with the early rejection guiding me toward She Writes Press, which has been a perfect home for this book.
What made you decide to go Indie, whether self-publishing or with an indie publisher? Was it a particular event or a gradual process?
See above J
Did you get your book cover professionally done or did you do it yourself?
She Writes Press really invests in cover designs—because people truly do judge books by their covers. A professional designer did my cover, and I love it.
Do you have a marketing plan for the book or are you just winging it?
I have a publicity plan and assistance from publicity professionals.
Any advice that you would like to give to other newbies considering becoming Indie authors?
There is so often a correlation between how much effort something takes and the sense of satisfaction we feel upon completion. If your dream is to finish your book and see it out in the world, try not to be dissuaded by the work required to make it happen, even if it takes a very long time. For me this process has spanned eight years, and I’m very proud of the work I’ve done.
About You
Where did you grow up?
I grew up in Greenfield, Massachusetts, which was the inspiration for The Untended both because of the opioid crisis there and because of the community’s strong response. The first review of the book that I received was from the trade publication Foreword Clarion, which said the following: “a community’s grit, hardiness, and sense of unity become apparent, even as its citizens struggle with addiction.” I was just so delighted by how the review really got the community aspect in the book.
Where do you live now?
I live in Amherst, Massachusetts, about a half hour from where I grew up.
What would you like readers to know about you?
For a very long time I thought that I wasn’t good enough, and that I was doing it wrong, and that I would never get there. It’s taken a lot of effort for me to cultivate other beliefs for myself. Today I see that I have as good a shot as anyone, that I’m doing this writerly thing in my own way (which is a strength, not a weakness), and that to “get there” is a state of mind: I am there.
What are you working on now?
I have an idea for an essay collection. Maybe it will hit bookstores in eight years, or sooner—or never. Lately I’ve been following inspiration rather than trying to force things to happen, and that’s brought me a lot more levity and joy.
End of Interview: