Ruined, emptied-out towns filled with rusting hulks of their mining past, long-shuttered storefronts, mobile homes twenty years past their expiration date, kudzu-overgrown Little League fields and locals who know they’re trapped even if they don’t know that ATV they just bought won’t drive them out of it — that’s the Appalachia of “Hazard,” a simple and poignant portrait of an America that’s been left behind in one of the most beautiful places on Earth.

It’s a taste of Opiod Appalachia, where the insidious oxy has embedded itself into the fabric, the economy and the life expectancy of people who can’t see the big picture. Big Pharma underplays the dangers, crooked doctors run a prescription flood-the-market business, even the “clean” locals get those scripts and resell the drugs to support themselves. And Big Rehab is end game, scamming insurance, state and federal resources to keep the whole cycle running and operating at a profit.

The second feature from Appalachian filmmaker Eddie Mensore (“Mine 9”) is an immersive gem of a drama and an 88 minute long argument for the survival of indie regional cinema. Because Hollywood sure as hell isn’t telling these stories.

Alex Roe of “The Fifth Wave,” “Forever My Girl” and the current “Billy the Kid” streaming series stars as Will, a young father, estranged partner, and an addict and addict’s son who knows how to steal, buy at a discount or finagle the pills that he and his kind can pop, snort or cook and shoot up.

At least he’s not a coal miner. “It’s s— work,” he tells his pain-wracked and now oxy addicted coal miner dad (Steven Ogg).

Sara (Sosie Bacon, you’ll recognize her “Smile”) kicked Will out of the house. She’ll raise their little boy Morgan on her own, if need be.

But “What if I had a plan and the bucks to back it up?”

Will’s dream, “getting out,” fleeing to Myrtle Beach and opening a t-shirt shop. He’s got cash saved up. But it’s how he earns that money — his “I got a house to paint” odd job lies don’t convince anyone — that has her keeping her distance. She’s nearly a year sober, and he isn’t.

And that “plan?” When he unloads pricy pills to some teenagers, we can see what’s coming.

So can the local cop (Dave Davis). He’s at home in the decay all around him, knows everybody and which park the locals shoot up in. Not just because he sets up trail cameras to catch addicts and dealers in the act. Because he grew up with Will. And Sara? She’s his sister. He alone on the underfunded force knows something has to be done before Hazard overdoses itself into oblivion.

Mensore took a Kentucky town’s name and used Harlan County, Kentucky as his gritty, authentic filming location. But “Hazard” could be anywhere from vast swaths of Southwest Virginia, West Virginia, mountain Kentucky, mountaineer Tennessee or the western Carolinas.

As someone who grew up near Appalachia, went to school there, took “Appalachian Studies” courses on the history and never-ending parade of exploitation there and worked and lived in the region, I keep one rule in mind when viewing films set this close to home.

Are the filmmakers, actors included, looking down on a blighted place? Or are they seeing it through the inhabitants’ eyes, and letting us see it the same way?

Mensore, a West Va. U. alumnus, gets it. The “dreams” — of Myrtle Beach or just a getaway to King’s Island amusement park in Cincinnati — are limited, as are the horizons. He catches a few non-actors showing off on their ATVs in the opening credits. This is not America’s Smart Decision Belt.

The world he shows us is a town and region wrapped up in co-dependency. Will barking at Officer John about what he’s trying to accomplish, when this abused woman needs her pills for pain, and the extras as income because she’s fled a bad marriage and lives in a van, speaks volumes. Such stories are everywhere in a region where intergenerational co-dependency is almost the only economic life left. Even if it’s killing people.

A muddled ending and the over-familiarity of the ground we’re covering dull the movie’s impact, but only a little.

Mensore gets it right and tells a story validated by journalism and every trip through the region and everybody you know who lives there. And Roe, Bacon, Ogg, Davis and the parade of non-acting Appalachians we glimpse along the edges of the frame let us feel they’re living it, even if only for the length of a film shoot in Harlan County, Kentucky.

Rating: R, drug abuse, sex, profanity

Cast: Alex Roe, Sosie Bacon, Steven Ogg and Dave Davis

Credits: Scripted and directed by Eddie Mensore. A Quiver release on Plex, Amazon Prime.

Running time: 1:28