5150 by Duncan MacLeod

A tale told by a young madman, 5150 is a firsthand account of a descent into madness, institutionalization, escape, recapture, and eventual release. The young protagonist haunts the gritty underbelly of the San Francisco Tenderloin in the 1980's. Psychosis and cigarette smoke intertwine in a coffee-ringed world of hairspray, dyed black hair, hobos, and hospital gowns.