You hit several of the story shortcomings.
This is mainly the fault of the author that tried to look for shock value scenarios using several expedients to avoid actually trying to go deep and face the hard questions and facts.
The story tries to be deep and explore difficult emotions and situations but the more you read it and get aquainted to the shock value style you see how actually shallow it is.
Most of the topics are dealt with only on surface level, trying pseudo therapy approach that leaves the player with literally 0 closure.
This is why you despise both Lacey and MC, because none of their behavious is explored properly by neither of them.
Lacey is covered by the silly brain damage excuse, even if it actually denied by her later in the game, claiming knowledge of what she was doing (wow she seemed like an actual human being in that scene), but it is quickly erased again.
Ketamine literally does not work like it is portrayed, it feels like someone read a study on a particular effect and then used it to build a narrative around it that does not make sense at all, ignoring everything else.
MC instead is never made to face anything aside of "I am jealous and angry" which are both very valid emotions in the situation, but they are portrayed as cardinal sins simply because the story asks for it.
MC also.underlines several times.how he is hurt from being abandoned, but what we are being told by others is that his problem is that Lacey enjoyed sex with other men.
This creates a total cognitive dissonance, since you cannot match what is being said in one instance completely contradicts what is said in another.
And obviously the whole "I am excited to see you with other men" which is so weak story and character wise that you know it was put there to leave the cucks satisfied.
Due to this MC "damage" is never fully.explored or respected, like properly respected from a phycological point of view, everyone rallies around Lacey and MC is left to rot and made to be the guilty part.
Speaking of cognitive dissonance, how can the player reconcile Lacey saying "plant the seeds and build like a garden" with the jealousy date and the "let's open the relationship in 2 weeks".
The game and story needed more branching and meaningful choices aside from how to fuck Lacey and which LI to pursue.
Add all the other issues I often talk about like accountability and crucial.points left open and the story takes a big hit in terms of immersion.