Pain management / Andrew Vachss.

Enhanced descriptions from Syndetics:

Andrew Vachss's previous novel,Dead and Gone, prompted theRocky Mountain Newsto say, "Starting a Vachss novel is like putting a vial of nitroglycerine into your pocket and going for a jog." With his latest thriller, Vachss turns the heat up a notch by dropping his career criminal and ultimate urban survivalist, Burke, in the middle of some of the most dangerously determined humans he has ever faced. Burke has gone "missing-and-presumed" from his native New York City, following a failed assassination attempt. The shadowy man-for-hire is scratching out an existence in the Pacific Northwest, waiting to see if it is safe to return. Without his underground network of contacts and connections, cut off from his own people, Burke is forced to abandon his trademark complex scams. Instead, he returns to what he refers to as "violence for money." When Gem, the professional border-crosser who calls herself his wife, brings him a job tracking down a runaway teenager, Burke finds himself in a long, dark tunnel of lies--lined with more games than players. Burke takes to the unfamiliar streets, quickly and brutally establishing a presence. The whisper-stream carries him to a fanatical group of criminal Samaritans dedicated to supplying adequate drugs for those suffering from chronic pain. Forced into a potentially deadly alliance, Burke walks the wire between betrayals, risking it all for a girl he has never met. Because the State-raised outlaw knows better than most that there are many kinds of pain. And many ways to "manage" it.