Reading about the opioid epidemic feels like navigating an outbreak of numbers. Fifty-nine thousand to 65,000: people who died from overdose last year. Sixteen percent: the increase in American opioid deaths from 2014 to 2015. Seven hundred and eighty million: the quantity of hydrocodone and oxycodone pills shipped to West Virginia from drug wholesalers. Fifty-eight: people who died of overdoses from January to June this year in Cabell County, West Virginia, alone. These are the facts we know, and they are each about as useful as a flashlight in a fog. They illuminate a single area, but the problem is the fog.

Heroin(e), a short Netflix documentary set in Huntingon, West Virginia, attempts to give us a clearer view of the opioid crisis. It tells us how one community lives under the combined weight of political negligence and corporate greed, offering a cross-section glimpse of this story’s various strata. It is shot with great sensitivity, alternating between stark realism and an accompany sense of the surreal; the street lights blur like magic in one sequence, making it all the more jarring when first responders try to save a passed-out woman in a bluntly lit Sheetz. The first sounds you hear in Heroin(e) are sirens, a warning: This is an emergency. In 39 minutes of film, it’s an emergency Huntington mostly confronts on its own.

There are three protagonists: a drug court judge, a fire department chief, and a street missionary—all women. These women have steady hands and clear eyes, and they understand the odds against them. “It’s sad when you can drive around this city and say, ‘Oh, somebody died there, somebody died there,’ but that’s the reality of this area,” fire chief Jan Rader says, pointing at houses from the window of her ambulance. At one, she slows to a stop. “This white house right there, we had two deaths in 2015.” It’s a small house with peeling paint; its windows betray no movement.

“When you add hopelessness and unemployment and lack of education on top of all that, it’s kind of like a recipe for disaster,” she says. “I feel like we’ve lost a couple generations, not just one generation.”

West Virginia is not a populous state, nor a rich one. It is the only state that sits entirely within the service area of the Appalachian Regional Commission, which was established by the federal government in the 1960s to address the region’s chronic poverty. And it is associated, to its own detriment, with coal. But as stereotypes go, coal now shares space with other malevolents. Say “West Virginia,” and people think Donald Trump and opioids. The crisis struck West Virginia with particular force. There have been so many overdose deaths that the state exhausted its indigent burial fund five months before the end of this fiscal year. In response, the president it voted for went back on his campaign promise to declare the crisis a “national emergency,” which would have automatically allocated federal funds to fight it.