Macklemore & Ryan Lewis’s “Drug Dealer” video is hard to watch, but it’s also a necessary watch. The song, released earlier this month, gives a harrowing account of what happens when doctors carelessly overprescribe medicine. And in the new, accompanying visual, Mack brings that ugly reality to life by depicting a painful withdrawal episode.

The Jason Koenig–directed clip begins with Macklemore sitting naked and hunched over in a shower, then twisting on a bare mattress in a room littered with drugs. Much of the video closes in on his sweaty, swollen face as he passionately raps about opioid addiction, rarely breaking eye contact with the camera. Featured singer Ariana Deboo also appears in the video, drowning in a sea of red and white pills.

“Drug Dealer” is the first new single from Macklemore & Ryan Lewis since they released their sophomore album, This Unruly Mess I’ve Made, earlier this year. Macklemore — who’s long been open about his own struggle with alcohol and drug addiction — recently discussed America’s opioid crisis with President Barack Obama in the MTV documentary Prescription for Change — watch it here.