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From the liner notes

Director Adam Wingard (Pop Skull, Home Sick) teams with screenwriter Simon Barrett (Dead Birds) for this shocker concerning a recovering alcoholic being pursued by her psychotic ex-boyfriend -- a dangerous serial killer who has escaped from prison. When Sarah (Amy Seimetz) left Garrick (AJ Bowen) and moved to the Midwest, she thought she would never see him again. These days Sarah has gotten her drinking under control thanks to Alcoholics Anonymous, and has a good job as a dental hygienist. She's just gotten into a relationship with fellow recovering alcoholic Kevin (Joe Swanberg) when she learns that Garrick is on the loose, and may intend to 'finalize' their break-up. Now, as Garrick drives across the country leaving a virtual sea of blood in his wake, Sarah and Kevin brace themselves for a violent confrontation.