A comfortably dilapidated old summerhouse on the Maine coast is the deceptively genteel backdrop for Roxana Robinson’s beautiful and terrifying Cost (Farrar, Straus and Giroux, New York, New York; 420 pages; hardcover $25), a novel about the dreadful price heroin exacts upon three generations of a loosely knit WASP family. Robinson is the author of five highly regarded works of fiction as well as Georgia O’Keeffe: A Life, the definitive biography of the American artist. Her fictional dissections of the American upper-middle class have been compared to John Cheever’s. But Robinson’s work is both more lyrical and emotionally devastating than Cheever’s: it exposes the raw mess that is the skull beneath the skin of even the most carefully maintained upper-middle-class countenance. [For the rest of this story, see the August 2008 issue of Down East.]

Julia Lambert is, by default, the unprepossessing matriarch of her small, estranged, ill-matched clan. A divorced painter and art professor at Columbia University, Julia is generous and kind-hearted, devoted to her two sons, nineteen-year-old Jack and twenty-one-year-old Steven, and to her elderly parents, Katherine and Edward. Cost opens with Julia preparing lunch in the summerhouse for her parents: eighty-eight-year-old Edward, critical and emotionally withholding, a brilliant former neurosurgeon who believes “that beds should be made and then lain in;” and the gentle Katherine. Two years younger than her husband, Katherine is just beginning to drift into the dark eddies of Alzheimer’s Disease: “Pieces of her mind were breaking off and floating away, like ice in a river.” Katherine’s mental deterioration is echoed in the slow yet inexorable decay of the shabby summerhouse, a place that takes on Chekhovian resonance as the novel progresses.

The family’s brief idyll is shattered with the arrival of Steven, who has just left Seattle, where he had a short, unsuccessful stint as an environmental activist.

Now he wants to pursue law school, but on the way to Maine he decides to make a detour to Brooklyn to visit his younger brother. A good-looking, feckless charmer, Jack is the problem child to Steven’s good son, living “a Gypsyish downtown life of start-up bands, part-time jobs, optimistic schemes, and the very occasional unpaid musical gig.”

He is also, as Steven almost immediately apprehends, a junkie. Secretly appalled, yet reluctant to betray him, Steven goes on to Maine. And there, during a hesitant and tense conversation with his mother, he utters the terrible word that casts its malign spell over the entire Lambert family:

“ “Steven,” Julia said. “You started this.”

“I’m not saying — ”

“You said ‘heroin’, ” Julia said. “You’re the one who used that word. Once you say it, everything changes. Now we have to do everything we can. You too.” She felt swollen with something, dictatorial. She felt terrified.”

Few works that attempt to capture the experience of heroin addiction, fictional or otherwise, manage to do so without allowing it a faint sheen of malignant glamour. Cost does not. Its relentless narrative is horrifying and unsparing, cold-eyed yet compassionate, in its portrayal of Jack’s plunge into the abyss and heartbreaking in its depiction of how his family is rent apart by his fall.

Heroin erases anguish, mental and physical. Those who seek it out are often in such severe psychic distress that oblivion and even death are preferable to living with insuperable pain. It’s a drug that fills an emotional vacuum, even as it creates a moral void in the addict.

Robinson’s title refers to the awful price exacted upon those who refuse to acknowledge their own pain, as well as that they inflict upon loved ones. And the Lambert family, with its well-intentioned, carefully constructed but ultimately fatal detachment, is a case study in the brutal cost of such poorly executed pain management.

As Cost’s spiraling narrative unfolds, points of view shift to include Jack’s entire family, called together for an intervention to get him into rehab. Robinson has a remarkable gift for describing the Lamberts’ disparate inner worlds, and also for observing the slender yet real bonds that link them. Katherine’s eroding consciousness; Julia’s maternal anguish; Steven’s mingled love and guilt and resentment; Edward’s denial and terrible lack of engagement with his own family; and most memorably, Jack’s increasingly fragmented psyche — all become as familiar as the faces of one’s own neighbors, and as unforgettable.

Cost is grim and unsparing, an account of a perfect human storm that leaves a terrible wake. It’s also impossible to put down, its bleakness relieved by Robinson’s elegant, restrained prose and breakneck pacing.

This is simply one of the most heart-wrenching and powerful novels I have ever read. “Love is not a word their family used,” Robinson observes, then shows us the inalterable cost to that silence.