Director: Sean Dunne

Early into Sean Dunne's profoundly upsetting documentary Oxyana, a middle-aged woman, living in the drug-riddled town of Oceana, West Virginia, says, with pain in her eyes, "People are scared to let their kids walk down the street." It's a statement that's both easily believed and tragic, two points that Dunne conveys masterfully in this all-access, no-editorializing look into the shattered and sad lives of those living in a town that's seemingly beyond saving.

Ten or so years ago, Oceana was a pleasant community thriving on its profitable coal mining business, but once that started to go belly up, legal prescriptions of Oxycontin and other painkillers quickly became the go-to means of commerce. Average folks began selling pills, and before long Oceana's once-happy residents turned into junkies, criminals, hookers, and, at an alarming rate, corpses.

Throughout Oxyana, Dunne allows his camera to do the work, letting the townsfolk dictate their own personal Oxy-related nightmares, and their words  hit like sledgehammers. A 23-year-old talks about how "half of my graduating class is dead" because of the drug. A doctor working inside the regional command center says that upwards of 150 people check into his place of employment per day seeking assistance, with at least one of them dying from an overdose daily. Someone gives an estimation that 70% of Oceana's inhabitants have been inflicted with Hepatitis C from needle injections. A homeless man who lives under a bridge points to a nearby gutter, calls that his wife's toilet, and mournfully says, "Drugs led me right here."

And Dunne isn't afraid to put the film's viewers right there alongside that man and his neighbors. Largely focusing on a handful of Oceana's citizens, the filmmaker doesn't pull back from showing his subjects in all of their addiction-triggered darkness. Numerous shots of folks sticking needles into their arms, followed by the equally calming and damning reactions on their faces once the drugs work into the bloodstreams, are startling at first but soon become like watching someone sink into quicksand.

Dunne's also able to elicit sympathy for people who, by their own self-aware statements, don't immediately seem empathetic. The town's biggest dealer, for instance, matter-of-factly discusses how he pays doctors $1,000 per month to obtain his product, but then, just when you're ready to consider him a villain, recounts a harrowing and horrific memory of when a loved one murdered his family over Oxycontin. Another, more inherently likable subject, meanwhile, uses the injections to fight against his brain cancer and speaks with a skipping-record stutter. Analyzing his difficult life, he rationalizes that "there's nobody who can take me except for God."

That anticipation of meeting the Man Upstairs is Oxyana's rare moment of optimism, albeit of the desperate kind. By the end of Dunne's eye-opening film, there's nary a positive tick with which the viewer can exit back into his or her own world—you're left angry, rattled, and wishing you could inject some hope into these people's bodies instead of the junk they're so dependent on. One interviewee says, "Nobody's gonna care—they think we're inbred pieces of shit." Only a heartless monster would feel that way about Oceana's lost souls after watching Oxyana.