Cole Freeman (Philip Ettinger, First Reformed) maintains an uneasy equilibrium in his declining Appalachian mining town, looking after the old and infirm in the community while selling their excess painkillers to local addicts to help make ends meet. But when his old friend, Terry Rose (Cosmo Jarvis, Lady Macbeth), returns with dangerous plans that threaten the fragile balance Cole has crafted, his world and identity are thrown into disarray.