I typically don't like short story collections and didn't realize this was a short story collection until halfway through the second chapter when it became clear that it was a different narrator.
Overall the stories are entertaining, heartbreaking, very readable, and mostly believable. I didn't realize OH was so white-trash, it reminded me of a holler I know of in Southern IN. A few of the narrators seemed too self-aware. It is one thing for the author (or other narrator in the third person) to comment on the fucked-up-ness of the character's life and choices, but quite another for the first person character to recognize that he needs to make some changes (this was most apparent to me in "Blessed"), especially if the character is currently high. Certainly, lots of people make the decision to get sober (and yes, most frequently it is while high that one decides they can be sober, once sobriety sets in the addict no longer wants to be sober, but decides to get high once again), but the argument to himself seemed much too clear headed for one who has just shat himself in public. The word choice and tone (especially in "Blessed") also comes across as too sophisticated. These are people who (when they speak) do not use proper grammar or tense, yet the prose waxes philosophical with complex thoughts and words. I think the third-party narration worked much better for the content and supposed mental state/educational level of the subjects.
There really wasn't anything upbeat or optimistic about these characters and the town, but I did enjoy the stories.