By John Lyle Belden

American Lives Theatre concludes its 2023-24 season as bold as ever with the drama “Spay” by Madison Fiedler, directed by Jen Johansen.

The setting is a recent September in Williamson, West Virginia (an actual town, hidden away on the Kentucky border). Noah (Jaddy Ciucci) has returned from the hospital, where she had been recovering from a very public heroin overdose, to the home of her half-sister Harper (Shawntè Gaston), who has custody of her pre-kindergarten son Benny (offstage).

The pains of withdrawal and pangs of addiction still rage in Noah, but she insists this time she can stay clean – as she had been for nine months prior to the recent incident. Harper, a no-nonsense kindergarten teacher, insists on assurances that this time will be different. Noah will live there, and in turn she pledges to break up with her boyfriend (and dealer) Jackson (Matt Kraft).  We soon see how thin her resolve is on that point.

As the days start to cautiously pass without a relapse, a stranger comes to Harper’s door while Noah is at work. Aubrey (Julie Dixon) has come from a city hours away to offer help in the name of an organization that specializes in aiding young women with addiction. Harper is naturally slow to trust, but Aubrey confides that she had lost her own daughter to addiction and brings up a lot of valid points and advice, forcing Harper to seriously consider more aspects of her situation.

However, this voice of reason also comes with a choice that seems unreasonable – at least, at first.

It has become widely known the alarming degree to which opioid addiction has ravaged the coal country of Kentucky and West Virginia (part of a nationwide epidemic). This fact, plus an excellent stage set (designed by Zac Hunter) with running water and comfy furniture, aid excellent performances to help the audience, seated on three sides around the Phoenix Basile stage, feel right there with these characters.

Ciucci employs her whole body in a convincing portrayal of near-constant physical and mental pain. Her manner of speech and expression, a variety of moods as damaged and disordered synapses keep her on a perilous edge of self-control, are convincing, while generating a surprising amount of situational dark humor. In her deceptively calm moments, there is the sense they will not last.

“This is a survival town.” That line by Harper sums up the feeling of a desperate need for stability and control that Gaston ably portrays. She has deep affection for her sister but finds herself forced into constantly employing it as tough love. And she is readily a fierce defender of Benny.

Kraft plays Jackson as a charming, means-well, naïve redneck. He seems to care for Noah, but a close listen to his words shows signs of narcissistic control, wanting her as both the girl addicted to him and the loving woman he wants to marry, seemingly blind to the contradiction. His often-infuriating presence adds to the humor.

Dixon plays Aubrey as a gently-revealed enigma, leaving it to us to resolve if she is more savior or bargaining devil. According to ALT artistic director Chris Saunders, organizations such as the one she represents do exist.

Given her long-time presence on numerous stages, it is surprising that this is Johansen’s directorial debut. She has brought her experience with the actors’ perspective to bear to bring out the best in this talented ensemble.

Also notable is the musical soundscape by Todd Mack, with its haunting Appalachian tones.

The play ends on a fraught note, with a decision made but the consequences yet to be seen. This would be infuriating in a movie (begging a sequel) but on the stage a common device to open dialogue about what was just seen and our feelings about it. Still, it was a bit of a stun, the cautious applause when the lights came up snapping us out of a trance, delivering us swiftly back from two states away. Still, those issues, we realize, are here in Indiana as well.

A stunning, engrossing look at a widespread problem brought home to the individuals mired in its depths, “Spay” runs through June 30 at the Phoenix Theatre Cultural Center, 705 N. Illinois St., Indianapolis. Get tickets at phoenixtheatre.org, information (including ALT’s coming 2024-25 season) at americanlivestheatre.org.