The title character is actually based on director Trey Edward Shults's cousin and Krisha Fairchild's niece Nica, a longtime addict who relapsed at a family reunion and died of an overdose soon after.
Billie Fairchild, who plays Grandma in the film, is actually suffering from Alzheimer's Disease, so she was not entirely aware she was acting in a film, although director Trey Edward Shults said she had a wonderful time at the "Thanksgiving."
Krisha is seen with a missing portion of her finger, which is never explained throughout the film; in real-life actress Krisha Fairchild lost the tip of her index finger while trying to break up a dogfight shortly before the start of filming. She wanted to back out of the film because of the injury but eventually agreed to stay on.
Filmed in nine days.