Water Imagery
The imagery of water is prevalent throughout the novel, even in the title: Drowning Is Inevitable. Olivia's mother, Lillian, committed suicide by drowning, and water takes on a special significance for Olivia. She feels the pull toward the water as well, and much of the language she uses reflects this preoccupation (drowning, flowing, dripping, etc.).
Bloodstain Imagery
The imagery of blood stains is prevalent as well, especially after that fateful scene in which Jamie kills his father. There is a lot of blood at the scene, and it stains Jamie's clothes. Olivia also gets some on her, and she washes herself of Mr. Benton's blood in the bathroom of a gas station, watching it swirl down the drain. When Jamie is killed at the end of the novel, there is also a lot of blood; Olivia doesn't want to get clean because part of him is still touching her. She is forcibly scrubbed clean, however, and the last of Jamie's blood swirls down the shower drain like his father's did.
Deterioration Imagery
The effects of substance abuse on important characters is seen through imagery that evokes images of their deterioration. Tom Benton's skin is described as hanging off, like he's wearing "a Mr. Benton suit." Maggie's mom, Vicky, is described as physically deteriorated as a result of her drug addiction: “Vicky Harrington looked like a dying child." Many drug addicts, seen in New Orleans, are also described in this way.
The House of Cards
The image of a house of cards is used to describe the four-way relationship of Olivia, Jamie, Max, and Maggie. When Jamie dies, the others collapse in grief and exhaustion, "like the house of fallen cards we'd become" (Ch. 13).