This is a set of three loosely interconnected stories about three sets of people, each gathering up speed as they circle around a whirlpool of drugs and despair and desperation.
The most fully fleshed out of these three groups is Genesis, a drug addicted prostitute who dreamed of someday getting out of Reno and Lupita, a one-armed chick with a blazing gun in each hand who somehow shows up on the spot to rescue Genesis. Their back stories are intense and are told well. Together, they follow Dillon's advice in Drugstore Cowboy that the drugs were all there in the pharmacies for the taking and cut a path of blood and gore across the west. Throw in a little bit of Haitian superstition and you've got two avenging angels out to take whatever they can get and who fall in love with each other on the way.
Another pair lives in a seedy Hollywood hotel, Jeffrey goes to AA meetings and his sidekick, tall thin transsexual Rachel, who turns tricks to keep them full of dope.