This book caught my interest as soon as I read what it was about. I was given a free download of this book from Netgalley and Simon and Schuster to read. I am leaving a review because I really enjoyed this book and wanted to share my own honest opinion of it.
This book delves into the opioid epidemic that has been on the rise for the last few years. I have used oxycodone for over 15 years to help control my chronic pain. Oxycodone is a long acting form of opium, I never had the feeling of euphoria that some people talk about, all it did was help but not take away all my pain. Once we found the dosage best for me, I never increased that dose and sometimes I took less than I was prescribed if I was not doing much that day. Due to the opioid epidemic, the abuse and addiction, I was told that I would have to get off it as the government would be taking it off the market. I have now been on Kadian a type of morphine for about a year. The time I was going off the oxy and on to the Kadian was the worst I had felt in years, my pain was so intense I threatened my pain specialist that if I didn't get relief soon I was taking oxy. My Dr. talked me off the cliff and put me back on nerve damage medication (lyrica) and a muscle relaxer (baclofen) and told me to also add extra strength tylenol as needed. When I made it through to the other side she told me I had done one of the hardest things I would ever experience. So I have some first hand knowledge of what this book is about. It takes place in Vancouver, Canada one of the most beautiful places on earth. It is full of high mountains, lovely forests and lakes, rivers and beaches. But inside this beautiful province is a very huge problem, ER room's are having a large number being brought in that are on the brink of death or dead from lack of oxygen. Dr. Julie Rees an ER doctor who also has experience with poison control, toxicology and Detective Anson Chen are on the search for what is causing all the deaths. This story takes us into the underworld of a beautiful city that is falling apart. I really enjoyed these two characters and the way they interact with each other, they keep the story from becoming too depressing with their fun banter. We also meet some absolutely beautiful people who have been affected by this epidemic that is running wild. There is more going on than meets the eye as it is discovered what has really happened and the race is on to get to the bottom of it before more innocent people die. This is the first book I have read by Mr. Kalla, but his writing has definitely caught my attention. Although this story is fiction, as a Dr. Mr. Kalla has first hand knowledge about the drugs and their affect. And I would imagine that some of the things that happen in the book are things he has lived through. If you enjoy a lot of action, suspense and a touch of romance that could actually be happening I'm sure you will want to read this book.

Received from Netgalley in return for a review. The Last High takes upon a topic very important for today’s generation: opioid addiction. The point of view is an interesting one, from a former addict. The main character, Julie has her flaws that are discussed immediately. I think I missed the element of surprise from The Last High. Since you receive the point of view from all characters, there wasn’t much left to be determined. But overall, it’s an interesting read and hope to read more from this author.

From start to finish, I liked The Last High. Wow! Talk about a timely subject, the opioid crisis … it sure is! The investigation in the story becomes complex, and the author does a great job of keeping it from being confusing.

The interaction between Julie (an ER doctor) and Anson (a detective) is very convincing. When several deaths hit Vancouver and are attributed to a specific lethal drug, Julie, who also works with Toxicology, and Anton swing into action. The minor characters add to the enjoyment along with an interesting back story.

The story was real as well as compelling and well written. The author’s expertise in the medical field most assuredly makes it believable.

Thank you to NetGalley for the opportunity to read and review The Last High. I enjoyed it immensely.

OMG!! I could not put this book down!! This story was so suspenseful that I kept holding my breath all the way thru! A book on how one little mistep could kill thousands! Even though this is a medical thriller, the Author has a way of making you think this will and can happen. This book was so good, that I bought the rest of his medical thrillers!! I have a new favorite medical suspense Author!!!

Usually, this author writes suspenseful books. This is not one of them.

While the subject matter is timely, the story fails to gain momentum and ends up being blah. I had to force myself to finish it. I was reluctant to pick it up.

Kalla trademark building of suspense is completely non existent here.

Did not want to put this book down. The theme is very timely and brings up some very scary possibilities. I expect the author is using his personal experience as the basis for the story. It is happening at some level and has the potential to become this story. The combination of the timely narrative and the medical mystery drew me in from the beginning and kept me engaged throughout the book. It felt like Patricia Cornwell, Michael Chrichton and Robin Cook - a few of may favorite mystery writers. I will seek other of Kalla's books after reading this book. One fly in the soup that got in the way of me fully loving the books was the odd decision of having Julia, a addict in recovery and supposedly sober, drink alcohol repeatedly. This simply is contradictory. A key element of the story is her role and experience as a sober addict. Why confuse and diminish it by adding her not really being sober into the mix? Strongly suggest a rewrite around that to make the story ring true. This lost it one or two stars in my rating.

An “addictive” thriller that blends the worlds of medicine and the underworld and ties them together with word’s off the latest headlines. Characters with personal demons, grudges, and moral determination band together in a full-speed pursuit to end an opioid crisis

I really enjoyed the medical mystery! There’s a touch of romance, but the story line focuses on Julie and Anson trying to figure out a new drug going that has deadly consequences. The story is told from multiple points of view (third person) that weaves together a tale of greed, murder, deception, and mistakes. While this is a medical thriller, the author thoroughly explains everything relevant so no it’s not confusing. Also, I’m from the US so I love that the story is set in Canada!

Thank you to.NetGalley for a free copy in exchange for an honest review!

This latest is another winner, one of those stories that grab your attention from the start, an awesome medical thriller that deals with the terrible opioid crisis. The Last High (TLH) is carfentanil, a derivative of fentanyl a drug so lethal who ever tries it may end up dead. The story takes place in Vancouver BC one of the cities where the crisis is at the highest level but although this city is in Canada, the crisis is certainly a worldwide occurrence that kills thousands of users. Mr. Kalla, an ER doctor by profession has penned a story of what happens when teens show up in the ER from a deadly drug overdose.

The development is said in alternate chapters from the point of view of ER doctors, the toxicologist, the homicide detectives, the dealers and their associates. The pace is a bit slow at first but as good thriller does it soon springs into action and from then on we are into a rollicking tempo till the very end. The plot has a lot of intrigue and some violence after all dealing with the Triad, major drug gangs and petty dealers, one cannot pussyfoot around. We find a lot of medical jargon and chemical references in the book regarding the illicit drug world; I learned a few things (actually a lot)……and following the cleaver police force at work we find out the tricks they need to do in order to get the drugs off the streets. “Chapeau” to them. Thank you, Mr. Kalla for writing such a lively and timely story to enlighten us as well as for our enjoyment.

I received an ARC from the publisher Simon & Schuster for my thoughts.

Wow …I think I just found my new favorite author. This book rates a solid 4-1/2 stars! I have huge respect for an author who is able to entertain us with his imagination …to put his creativity into such story telling …I am quite envious! There were lots of twists and turns that kept the story entertaining and fresh! There was a great job done in the development of the main characters and the seconds! This was a fun book to read as I used to live in Vancouver, many moons ago, so I am familiar with all the streets and areas that were mentioned in the book (and it wouldn’t be too much of a stretch to guess which hospital Dr. Kalla works at!!!) I will definitely be looking for more novels from this author!

I would like to thank Dr. Kalla, the publisher and NetGalley for an advanced copy in return for an honest and unbiased opinion of his book

Great, fast-paced read!! FIVE STARS!!! Kalla does an exceptional job at drawing us in from the beginning and keeping us on the edge of our seats until the end. The writing is top-notch with well-defined characters and a believable story line. Where so many novels are tripping over themselves to out-twist each other, this could be something that truly happened in any major city. Set in Vancouver, “The Last High” delves into the opioid crisis and how it is greedily and devastatingly ruining lives and families. This novel is set to be released in May of 2020 and I highly recommend it!! Disclaimer — I received this book for free from NetGalley in exchange for an honest review. Thank you to NetGalley and the publisher! #NetGalley 🤩🤩🤩🤩🤩

3.5 Stars rounded up to 4.
The author, Dr. Daniel Kalla is an ER doctor in Vancouver. He writes with firsthand knowledge of the medical and personal results of the opioid crisis and has researched the criminal side from the law enforcement perspective. He mentions that thousands have died in B.C. from opioid overdoses. He conveys the suffering and loss associated with this devastating drug.

I read his exciting previous book, We All Fall Down, which discusses what might happen when a new disease threatens to reach pandemic proportions. Both medical thrillers concentrate on timely issues.

The author mentions that fentanyl, now causing many deaths, is 100 times more powerful than heroin. The drug in this plot, carfentanil, is said to be 100 times stronger than fentanyl. The goal of the toxicologist and police in this story is to stop the manufacture and distribution of carfentanil before numerous deaths occur.

It is first noticed when a group of teenagers are rushed to the emergency room from a party on the brink of death or headed to the morgue. Dr. Julia Rees, an ER doctor and toxicologist recognizes that they have succumbed to something even more deadly and that kills more quickly than fentanyl, the present scourge of drug addicts. Soon others die from the same illegal drug; a street user, an airplane pilot, and a lawyer along with three of his party guests.

Julia realizes that if the source of this narcotic isn’t found quickly, many more will die. She is haunted by the death by overdose by her lover nine years ago when she had also been addicted. Joining up with Detective Anson Chen and other officers in drug enforcement, they must follow a difficult and convoluted path. They must find and investigate drug users, street pushers, phone dealers, and wealthy gang leaders who import and supply illegal drugs. It is essential they locate the person cooking the lethal carfentanil and passing it off disguised as another drug. To penetrate this complex drug net, they must confront many users, the families of the victims and users, dealers, suppliers and importers. This leads them on a suspenseful and thrilling chase in an effort to stop the drug before more reaches the streets.

For such a complicated investigation, many character’s names were mentioned. I believe this was necessary to tell the story, but it slowed the pace for me. Also, I wondered if an ER doctor like Julia could leave sick and injured patients in the hospital to get so intensely involved with the work of the police, and time to develop a romantic attachment.

I found this story well researched, realistic, and informative about the devastating opioid crisis. Many thanks to NetGalley and Simon & Schuster for this compelling medical thriller in return for an honest review.

My first experience with this author won't be my last! A medical thriller written by a Canadian doctor and set in Vancouver BC Canada.

The opioid epidemic floods the ER of a Vancouver hospital dragging Dr. Julie Rees into tragic flashbacks. Working along with Det. Anson Chen of the Vancouver Police Department, Julie's toxicology knowledge helps trace back a batch of fentanal that is so powerful it leaves user dead in minutes.

The characters are well developed, the plot a steady flow of medical procedures, the police investigation intriguing, and a developing romance to round out all of the emotional aspects.

Only one '"unable to believe this' part" is breastfeeding right after heart transplant surgery. I enjoyed the tour of Vancouver - brought back a lot of good memories.

What an incredible story. I couldn't put the book down until I finished it.
This book touched a part of my heart that has been healing for a few years now. Fentanyl was involved in the overdose of a young lady that was very special to me. Superb writing, and I loved the characters. Julie and Anson are very believable in their character roles.
I wish everyone would read this book, to see the dangers of opioids.

This reminded me alot of Louise Penny's Kingdom of the Blind - tackling the drug trade in Canada and the devastation of the opioid epidemic. The book was a quick read and all the characters felt fleshed out, even the minor ones. I liked the main protagonist, Dr Julie Rees, and her relationship with those around her. One of the things that nagged me a bit was the over explanation of jargon, it stopped the flow of the dialogue and felt a bit stilted each time. Overall a solid book in the genre that is depressingly growing.

The Last High is an in-depth medical/crime suspense story. The story centres around the rampant drug abuse in Vancouver which is a large problem for this Canadian city. While Julie is working a night shift in the ER she is faced with a group of teenagers that all arrive by ambulance after a drug overdose. All of the teens die with the exception of two, one who is doing well and the other who Julie keeps alive by putting her in ECMO, against the cardiologists advice. Due to the fact they all died quickly and the same way she realizes that they were poisoned high is confirmed by her friend Anson, a police detective who finds no drugs or paraphernalia at the scene. What follows is a deep investigation into the drug world. There seems to be a lot of research into the city itself and they groups/gangs that make and supply the drugs to the dealers, making this not only realistic but interesting to read. Julie is an Addict herself, 9 years in recovery and this drives her to dig deep with Anson to find the truth. I really enjoyed this book and the characters. Julie and Anson are well developed characters. This book will keep you guessing and is a good mixture of police, medicine, crime and a touch of romance that is not out of place. The only issue I have with the book is the ending which seemed to be rushed. Thank you NetGalley and Simon and Schuster Canada for the opportunity to read this book.

Thank you to NetGalley and Simon & Schuster for the opportunity to read this book in exchange for an honest review.

Daniel Kalla has written another blockbuster of a book. It's extremely well-written and up-to-date on current affairs. As an ER Doctor on the front lines of the opiod crisis the details in this book set it apart from any other book written.

The main characters are Dr. Julie Rees an ER doctor at St. Michael's Hospital and a toxicologist for the Poison Control Centre. Detective Anson Chen is with the Vancouver Police Department. Detective Chen's partner is Detective Theo Kostas and the three of them are determined to find out who is putting 'The Last High' on the streets.

It all starts at a party where 6 teenagers OD. Except for one, they are all dead. Did they know what they were taking or was it an accident? They have to find what links teenagers, a pilot, a developer, a junkie, a nun - people from all walks of life who either take drugs or are exposed in some way. No one is talking in Vancouver but someone is putting this lethal mix on the streets. There are several layers of middle-men and no one will admit to being in charge. Several different groups control the drugs on the streets but Julie and Anson are determined to find out where 'The Last High' is coming from.

An incredible real-life page turner. As always Daniel Kalla is a brilliant read that I would highly recommend to anyone that is not familiar with his books. They are all worth the read.

Riveting from the first lines. Grabbed me and sucked me in on the first page.

Being a critical care nurse, and loving nothing more than the pump of adrenaline from an emergency situation...I was surprised at how well written the medical aspect of this book was. It really drew me in and left me wanting more.

I liked that the novel showed many different perspectives of the variety of characters, splicing them all together to form a full story, but always coming back to Dr Julie’s perspective. It really helped to draw attention to the varied perspectives and lives impacted in the drug epidemic (not sure this is the word I’m looking for, but for lack of others in my mind currently, that’s how I’ll refer to it) impacting many major cities in the Western world.

I found the investigation to be interesting, but was a bit put off with how involved Dr Julie, an emergency physician and toxicologist, was in it. She’s not a detective, so why is is she involved in stake outs and meetings with suspects?

All in all, an interesting book that ties itself up rather nicely!

<i>I would like to thank Netgalley and the publisher of this novel for allowing me to read this advanced digital copy in exchange for an honest review!</i>

Thanks to netgalley.com for the opportunity to read this ARC. This medical thriller grabs and keeps your attention from start to finish. Physicians, police and families find themselves in a race against the clock to determine where a powerful new strain of opioid is coming from and why users can’t be revived even with multiple doses of Narcan. The reader moves through the streets of Vancouver with the police (and the ER physician who treated a group of young victims) searching for answers. As they meet and interview the players in the multi-layered drug production and distribution chain it becomes apparent that a product with lethal potency has been created and no one seems to know who made it and who is selling it. The book is technically well crafted and the story moves quickly. I look forward to reading more of this author.

Thank you to Netgalley for the arc of The Last High. What a great medical thriller! Julie is an ED physician and a toxicologist who is on staff the night a group of teenagers arrive in full cardiac arrest due to an opioid overdose at a party. Little do they know, a new drug, referred to on the street as TLH, has hit the streets and it’s killing people at an alarming rate. Being a respiratory therapist myself (thanks to the author for the acknowledgment of RT staff in the ED), I found the medical jargon accurate, believable, and relevant to the story. I knocked one star off for Julies annoying insistence on following cops around and trying to insert herself into dangerous police business...is being an ED physician AND a toxicologist not enough for you!? Overall great story that I really enjoyed.