F**khead is the unnamed narrator of the stories, an American born in the 1940s who struggles with severe substance use disorders throughout the 1970s and 1980s. Drifting through rural midwestern towns and various hospitals, he frequently experiences hallucinations, premonitions, and chaotic emotions. He struggles with taking responsibility for his actions, approaching life with a mixture of apathy and deep insecurity.

Jack Hotel is a man who frequents The Vine and shares F**khead's struggles with substance use. He wears an olive-green three-piece suit and keeps his blond hair combed back. He serves as a tragic reflection of F**khead's own life, drifting through the legal system and the local drug scene with a sense of underlying doom.

Georgie is an orderly who works alongside F**khead at an emergency room. He has a severe substance use disorder that frequently impairs his judgment on the job, leading him to steal pills and interfere with medical procedures. Despite his erratic and dangerous behavior, he views himself as a highly competent medical professional.

Wayne is an aging man who spends much of his time at bars and occasionally finds unconventional ways to make money. He recruits F**khead to help him strip copper wiring from an abandoned, flood-damaged house. He presents a kinder demeanor than many others in F**khead's circle but remains trapped in cycles of alcohol use and nostalgia.

Dundun is a drug user who lives on a farmhouse and occasionally supplies opium. He is characterized by his extreme and casual relationship with violence, reacting to severe situations with chilling apathy. Despite his capacity for brutality, F**khead suspects there is a hidden kindness in him.

McInnes is an acquaintance in the rural drug community who suffers a gunshot wound at Dundun's farmhouse. He is the person responsible for giving F**khead his derogatory nickname, a fact that causes F**khead to harbor deep, lingering resentment toward him.

Michelle is F**khead's girlfriend, a woman he considers incredibly beautiful. Their relationship is highly volatile, fueled by mutual substance use and profound instability. She faces difficult personal and medical decisions that strain their already chaotic bond.

Bill is an older patient and F**khead's roommate at Seattle General. He carries the physical and emotional scars of a violent past, having been shot in the face during prior domestic disputes. He accepts his traumatic history as a normal part of his life and worries about how others perceive him.

Kid Williams is a former boxer who frequents The Vine. He arrives at the bar straight from a detox program, symbolizing the cyclical and often inescapable nature of addiction within the local community.