A fierce, luminous memoir about the life and death of a young woman who struggled with addiction, the systems that failed her, and her sister’s quest to understand what might have saved her—and could still save others

Like many Americans, Madelyn Linsenmeir fought for years to recover from opioid and stimulant addiction—attending 12-step meetings, going to inpatient treatment, attempting to access medications. But no matter how hard she tried, or how much her family tried to help, Maddie continued to relapse; each time, the consequences were more severe.

So her oldest sister, Kate O’Neill, was relieved when Maddie was arrested. She’d been unhoused for months, and every day brought new headlines about overdose deaths. If her sister was in jail, O’Neill believed, at least she was safe. A week later, Maddie was dead, not of an overdose but a treatable heart infection.

Grieving not just Maddie’s death but everything she’d endured while she was alive, O’Neill wrote an obituary that openly addressed Maddie’s addiction. It went viral as people recognized themselves—or their children, siblings, parents, partners, or neighbors—in Maddie’s story. Soon after, O’Neill quit her corporate job and began reporting on addiction, trying to answer the questions that haunted her and her family: Why couldn’t Maddie recover, despite how hard she’d tried? Why did she die? What might have saved her? 

Blending intimate family narrative with an investigation into the forces that shape the lives of people who use drugs, O’Neill reconstructs her sister’s life and examines the systems that led to her death. In so doing, she challenges how we understand addiction and define recovery, finding hope in approaches that are already saving lives and sharing hard-won wisdom for surviving systems meant to punish instead of protect.

We Grow Accustomed to the Dark is the unforgettable story of one family, a devastating account of our national addiction crisis, and an urgent call to replace stigma and punishment with compassion and care.