People, Places and Things didn't make Denise Gough's career - she'd been putting in classy performances for yonks before starring in Duncan Macmillan's thrilling, existential study of addiction - but it didn't half give it a leg-up. It catapulted her into a legendary stratosphere, where her name-shifting drug addict actress rubs shoulders with Mark Rylance's Johnny Byron, Imelda Staunton's Mama Rose and Billie Piper's Yerma.

For Gough, People, Places and Things was a springboard into Marianne Elliott's Angels In America, and now onto Broadway to revive her performances in both. Which means, of course, that she's unavailable for the touring iteration of Jeremy Herrin's production. Which means there's a sizeable pair of rehab clinic slippers for Lisa Dwyer Hogg to fill.

First things first: Dwyer isn't as good as Gough, whose shadow flits through this production like a hallucination, but she's pretty great nonetheless, investing Macmillan's story of one woman's struggle against substance abuse with a fragile, febrile energy. Dwyer's is a more delicate, less dominating performance than Gough's, but she retains Nina/Emma/Sarah/Lucy's captivating cocktail of sneering cynicism and fierce intelligence, and still manages to suggest that her character's compulsive lying is driven by a deep-seated existential angst.

She's better – tearjerking, in fact – at the emotional stuff than the withering, scornful wit – there's more laughs to be squeezed out of Macmillan's text than she manages – but comparing her interpretation and Gough's is like comparing a tropical storm and a hurricane. One is more powerful than the other, but they both knock you flat. By anyone's standards, Dwyer's is an extraordinary performance.

And any slack left after Gough's departure has largely been taken up by Macmillan's play, which actually resonates more today than it did two years ago. The chaotic, cruel universe that tipped Nina/Emma/Sarah/Lucy over the edge in 2015 (ah, remember 2015?) looks comparatively cosy from here.

What was startling about People, Places and Things in its original incarnation was how logical, how rational even, Macmillan made self-medication sound in a world that didn't make sense. The world makes even less sense now, and that terrifying thesis even more. Brexit, Farage, Trump, Katie Hopkins – who wouldn't want to be off their face? Who wouldn't want to forget it all and "live life vividly?"

Herrin's production - a trippy, tricksy staging filled with pounding beats and flickering strobes – was always best-suited to the Dorfman, but it's been translated for touring without losing too much slickness. Dwyer's supporting cast, most of whom have little more but an addiction anecdote for a character, are excellent as well. Gough may have flown this particular cuckoo's nest, may have kicked this particular drug, but it's still one hell of a high without her.

People, Places and Things runs at Theatre Royal Bath until 21 October and then tours the UK until 25 November.