Spoiler warning: Being a synopsis, this covers all of the main plot points of the book from beginning to end.
In a mysterious, dark town in 1992 America, a nameless amnesiac befriends and rescues a sex-trafficking victim. The two teenage girls name themselves KADE and CARE. Kade experiences disassociation and terrifying visions when touched, and Care is a boisterous, cynical drunk with an unstable personality. On the run, the duo must survive the town full of corrupt police and psychopathic criminals.
After shoplifting clothes to stay warm, a boy their age named DRYDEN tries to drug and rape them, but Kade defeats him in hand to hand combat, displaying an increasingly uncanny set of nearly superhuman skills. Kade stays up on amphetamines to watch over the comatose Care, who wakes up thrilled about the huge bag of drugs and alcohol Kade stole from Dryden.
They start to sell the drugs for cash to skip town, starting at a party where Care deals ecstasy with help from a stranger named JACKIE. The party gets busted and Kade and Care flee to a tent in the woods.
Abusing alcohol increasingly, Care spills graphic details about her past, having been horrifically abused and forced to abuse others. She insists she is as corrupt as her former abusers. Care and Kade take hallucinogens, culminating in a sexual encounter which Kade mostly blacks out but regrets.
Next morning, they arrange a risky drug deal with some skater kids for the next day. Kade is unsure, but Care insists on the plan and continues to pressure Kade to drink with her.
Care awakens to Kade, bags packed to leave town immediately rather than gather more cash. Care follows, claiming she tried to escape before but was recaptured. When they get lost in a seemingly infinite loop in the woods, Care breaks down, and Kade agrees to stay and move forward with their drug dealing plan.
During that exchange, an older boy tries to rob them, but Kade robs them instead. Showing expertise with a stolen handgun, she decides they need ammo for it.
Meeting hillbillies gambling on teenage fighting matches, Kade bests an undefeated fighter, winning money and a tip on a local gun dealer. They locate him, a good-natured and heavily-equipped veteran named WALL WILLIAMS. After a brief standoff, they convince him to equip them.
Care continues to abuse the stash of drugs and alcohol. They reluctantly agree on a last ditch deal with a notorious character called the Devil. Care initiates another sexual encounter, causing Kade to descend into fragmented visions of her forgotten past. Coming to, she pushes Care away, alienating her friend.
Quietly at odds with one another but desperate, they go to the Devil’s, who litters them with money before betraying them. They flee to his basement, only to become separated in an endless maze of supernatural horrors. Kade breaks through the illusion, rescuing Care, but an alarm draws police to their location.
During a blazing car chase and shootout, the police capture Care, while a murderous blonde named HERA ambushes Kade. Hera reveals herself and Kade as agents of a shadowy organization called the SPIDERS, which seeks to recapture Kade. Hera is instead bent on revenge, as Kade nearly killed her sometime back when Kade’s mind control conditioning failed.
Hera shoves a knife into Kade’s belly in the streets, but Kade is saved by a mutilated torture victim she had released from the Devil’s garage just minutes earlier. She flees to Wall Williams, wounded.
Wall implores Kade to forget Care and save herself. Kade refuses, saying they can’t ignore the conspiracy that created her and entangles them all. Wall’s two highly-trained sons insist they must help, and the friendly girl Jackie from the party steps in, revealing herself to be Wall’s niece, the eyes and ears of their family’s ongoing covert operation to counteract the dark forces in town. Wall reluctantly agrees to help.
The next morning, Kade takes a rookie cop hostage at the police station to discover Care’s location. She releases him before blowing the station up.
Kade walks alone into the heavily-guarded brothel she first rescued Care from and finds Care held hostage by the Spider that mentored her. Kade neutralizes his mind control programming with her voice- the secret key that makes her so valuable- and saves Care during a barrage of supporting fire from Wall and his sons.
Care and Kade make it to a semi-trailer truck arranged by Wall and escape town with much of their money. The mysterious driver drops them in a new town farther east, where the duo is shocked to realize they’ve been transported nearly twenty years in the future.