This movie is a gem
It is cold, hard, precise, and beautiful. I just saw it after years of hearing about how great Vera Farmiga is in it, and she certainly is amazing, playing a long-time addict who is fighting her addiction with not many resources and dealing with its fallout with a dignity you wouldn't guess such a seemingly fragile person could possess.
The other actors, the cinematography, and the script are all top notch.