NEW YORK, NY.- In the escalating series of calamities that constitute Joe’s misadventures with alcohol, his middle child, Ricky, has missed a lot.

It’s been six gruesome years since Ricky last traveled back to Arizona for a family visit, after his father’s second arrest for driving drunk, and Joe has careened downhill in the interim. When he goes in search of vodka these days he goes on foot, but his sodden brain is shot: dementia, hallucinations, the kind of aphasia that means he can’t talk anymore. He grunts and lurches, vomits a lot, uses a corner of the TV room as a urinal.

Ricky has kept a determined distance from it all. When he does show up one summer night — threatened into it by his exhausted sister, Angelina, their father’s live-in caretaker — the recriminations start immediately.

“I can’t fly across the country every single time his organs start shutting down,” Ricky says, with the casual hyperbole of the repeatedly traumatized.

“You could’ve at least come for the kidney!” she shoots back.

This is a horror show, unequivocally. But John J. Caswell Jr.’s “Wet Brain,” at Playwrights Horizons, is also a very funny, pitch-black comedy about addiction and obligation, love and abandonment, and patterns of poisonous behavior lodged so deep they seem encoded. Also, Joe may or may not be in contact with aliens, so there’s some space travel along the way.

Directed by Dustin Wills in a coproduction with MCC Theater, the play takes place in the rundown house in Scottsdale where Ricky (Arturo Luís Soria), Angelina (Ceci Fernández) and their brother, Ron (Frankie J. Alvarez), grew up, raised by their father (Julio Monge) after the death of their mother, Mona. The loss of her haunts them still, three decades later.

The fallout of their father’s addiction and mother’s absence is everywhere in the lives of these siblings, each struggling with various compulsive behaviors, and possessed of a precision-honed ability to push the others’ buttons. Ron, the most like their father and the most protective of him, is also rancidly homophobic; he taunts his gay little brother, Ricky, relentlessly.

As with Caswell’s political horror drama “Man Cave” last year, design is the flashiest element of “Wet Brain,” giving us a window into Joe’s hallucinations and a surreal means for the whole family to gather, Mona (Florencia Lozano) included. (The set is by Kate Noll, lighting by Cha See, projections by Nicholas Hussong, sound by Tei Blow and John Gasper, and costumes by Haydee Zelideth Antuñano.)

“Why did you burn holes through your brain, Mr. Joe?” Mona asks her husband, gently.

Both of them are past the point of no return. This play’s dearest wish is for their children: that they find a way to heal.

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‘Wet Brain’

Through June 25 at Playwrights Horizons, Manhattan; playwrightshorizons.org. Running time: 1 hour 35 minutes.

This article originally appeared in The New York Times.