The film begins with an advertisement for New West Recovery (NWR), a rehabilitation center in Los Angeles, founded by the former addict, Vin. In his narrative, Vin takes pride in the transformative power of the Affordable Care Act, which he claims has made drug addiction and recovery recognized pre-existing conditions. This shift has sparked a massive industry of treatment clinics throughout Southern California.
Meanwhile, in Columbus, Ohio, a homeless couple, Utah and Opal, resort to robbing convenience stores to finance their drug habit. Opal also supplements their income by engaging in sex work for truck drivers. While out panhandling, they cross paths with NWR sponsor Wood, who offers them a meal and a chance at rehabilitation. Initially, Opal perceives Wood as a religious zealot, yet he clarifies that he simply seeks to provide drug recovery options. Ultimately, Utah accepts his offer and heads to Los Angeles with Wood, while Opal, deeply entrenched in addiction, opts to remain in Ohio.
A few weeks later, it's evident that Utah is making progress, and he tries to convince Opal to join him. However, she remains unyielding and uninterested in treatment. With Wood's encouragement, Opal finally chooses to become a patient at NWR, which brings Utah a financial reward for his referral. Utah, now following in Wood's footsteps, becomes involved in multi-level marketing for NWR, reaping significant profits from other referrals, inflated medical tests, and unnecessary procedures. Vin, through his narration, boasts about his intricate schemes, while Utah grapples with his conscience.
Initially, these fraudulent activities seem to be harmless and victimless; however, the situation escalates when the unethical Dr. Riner demands a larger share of a controversial procedure and belittles both Wood and Utah. In a fit of rage, Wood kills Riner and conceals his body. Following this incident, Vin advises Wood and Utah to leave town temporarily and maintain a low profile.
Not long after, Vin arranges for Utah to meet with a new referral at LAX. Before they even set foot in NWR's facility, Utah allows the patient one last fix. In a tragic turn, as the man succumbs to unconsciousness, Utah succumbs to temptation, resulting in a fatal overdose. It becomes evident that Utah's vulnerability to relapse was deliberately exploited by Vin to tidy up the aftermath of Riner's murder.
The film concludes with an epilogue highlighting alarming statistics on addiction and overdoses, underscoring the prevalence of similar criminal enterprises like NWR, and asserting that twelve-step programs remain the most effective and cost-free means of treating addiction.
