Graphic depictions of self-harm and suicidality, very abusive relationships that include rape, beatings, attempted murder, and strangulation, plus sex work depicted in the most unpleasant way possible. Substance use and mental illness. There is also a surprising amount of violence, considering this is a book where even the "bad girl" characters swear with "fudge!" Also, it's Piers Anthony, so expect girls jiggling boobily.