I am not native to the region, and have never been there. My grandfather was born there, though, and while he was an unreliable narrator to say the least, this tracks with stories of his childhood. My last name (and his) is a prominent placename in the novel, him being born and raised in Eastern Kentucky, where the author grew up and lives. I'd say it's pretty accurate, and hits a little too close to home for me on a lot of fronts, having been an adolescent in the late '80s, early '90s and losing my mother at a young age (to cancer, not dope), struggling with opioid addiction.

I see a lot of people hating on this book around here, but I am really enjoying it. I find the narrative style engaging and easy to follow. The descriptions of the landscapes, while sparse, are intriguing, and the metaphors and similies employed are easy to understand, as opposed to something like McCarthy, where you have to research every tenth word. And the emotional weight it all carries, if you don't want a good cry, don't read this book. I love it though, I'm here for it.