Sara Moore Wagner's "Hillbilly Madonna" is a harrowing and ultimately hopeful lens into rural life and the opioid crisis. Rendered with crucial honesty, these poems center women's experiences in Appalachia and reveal their often-overlooked stories and perspectives. Simultaneously tender and biting, "Hillbilly Madonna" ushers in a vital new voice in poetics, one that will stick with readers far beyond the wooded foothills of Ohio.