A little boy is in the back of an SUV. He's wearing a colourful shirt with cartoon dinosaurs.
As he sits there, staring at the camera, the two adults in the front lie lifeless.
Both, according to police in Ohio, frozen from a drug overdose.
The haunting image was shared on the city of East Liverpool's Facebook page on Thursday.
The unconscious woman in the passenger seat was Rhonda Pasek, said police, and the boy is her four-year-old grandson.
Photo shared as a warning
"We feel it necessary to show the other side of this horrible drug. We feel we need to be a voice for the children caught up in this horrible mess," said the city in the Facebook post.
"This child can't speak for himself but we are hopeful his story can convince another user to think twice about injecting this poison while having a child in their custody."
According to a police report, East Liverpool police officer Kevin Thompson spotted a Ford Explorer driving erratically on Wednesday before it drifted to a stop in the middle of the street.
The man at the wheel, identified as James Acord, told police he was taking Pasek to the hospital.
The officer said Acord's head was "bobbing back and forth."
As he tried to drive the SUV again, Thompson reached in and removed the keys. That's when he noticed the boy in the back seat.
"We are well aware that some may be offended by these images and for that we are truly sorry, but it is time that the non-drug using public sees what we are now dealing with on a daily basis."
The driver then lost consciousness, and Pasek was turning blue. Paramedics arrived on the scene and administered a drug called Narcan, which is used to reverse opioid overdoses.
The couple eventually gained consciousness and were taken to a hospital. The boy is in custody of children’s services, according to an affidavit.
"We are well aware that some may be offended by these images and for that we are truly sorry, but it is time that the non-drug using public sees what we are now dealing with on a daily basis," the city said on Facebook, adding that heroin has taken a "strong grip" on many communities.
Acord, 47, was sentenced to 360 days in jail, reported the LA Times, after he pleaded guilty to child endangerment and operating a vehicle while intoxicated.
Pasek, 50, was charged with endangering children, public intoxication and not wearing a seatbelt.
CLARIFICATION: The police report originally identified Pasek as the boy's mother; in fact, she is his grandmother.