The author's personal story is wild and depressing, but his writing about it is captivating and entertaining. I grew up in a small post-industrial town and have seen Mountain Dew mouth and a much more sinister opioid epidemic take hold. So I 100% relate to the picture he paints of Appalachia in decline. I wish I could give it more stars, but the macro-level conclusions he comes to about how to remedy this sad state of affairs really miss the mark to me. There's some sentiments I agree with (i.e. we as communities need to do a better job supporting one another), but strongly disagree with the author's view that government programs aren't able to seriously address these issues and prevent the sorry state much of America is in. No amount of bootstrap pulling can solve these dire issues.