Trocchi acquired his lifelong heroin addiction in Paris. He left Paris for the United States and spent time in Taos, New Mexico, before settling in New York City, where he worked on a stone scow on the Hudson river. This time is chronicled in the novel Cain's Book, which at the time became something of a sensation, being an honest study of heroin addiction with descriptions of sex and drug use that got it banned in Britain, where the book was the subject of an obscenity trial; in America, however, it received favourable reviews.
Trocchi was then deep in the thralls of heroin addiction; he even failed to attend his own launch party for Cain's Book. His wife Lyn prostituted herself on the streets of the Lower East Side. He injected himself on camera during a live television debate on drug abuse, despite being on bail at the time. He had been charged with supplying heroin to a minor, an offence then punishable by death. A jail term seemed certain, but with the help of friends (including Norman Mailer), Trocchi was smuggled over the Canadian border where he was given refuge in Montreal by poet Irving Layton and met up with Leonard Cohen. His wife Lyn was arrested and son Marc detained, but later joined Trocchi in London.
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