
One of the reasons I love LOST is that it constantly engages the mind with its subtle metaphors. Most episodes are written so well that you can either appreciate the story at face value or, with an occasional nudge from the writers, dig a bit deeper.
Unfortunately The Moth is not a "nudge", it's a sledgehammer to the skull.
When Locke first leads an agitated Charlie to a moth cocoon, he explains that he could expedite the hatching process by slitting the one side with his knife. But that, of course, would be counterproductive and negate nature's plan of strengthening the moth. Since Locke took Charlie's heroin stash and put him on the brink of a painful detox, this was an effective metaphor. It should have stopped there.
The moment Jack was trapped in a cave-in was the first time I was ever tempted to roll my eyes while watching LOST. Not only was it a bit too convenient — Charlie was standing right next to him yet managed to escape? — the arc of the episode became painfully obvious. I certainly didn't believe this "crisis" was going to extend beyond the episode or ever be mentioned again.
Hero-in-progress Charlie "rescues" Jack and sees a moth fluttering within toward a passageway. Ugh. Metaphor Part Two. He predictably climbs up to the surface, the Losties all hug each other and rejoice. And then... are you serious? Locke and Charlie stand together once more, and Charlie sees ANOTHER moth fluttering away. He stares dreamily into the night sky, [LOST]. Good gravy.

Putting aside my gripes with the writing, this was a shining moment for Dominic Monaghan in terms of acting. He completely sold the sweating and shakes from detox on the island, but more importantly played a lost, conflicted soul torn between his religious convictions and the temptations of stardom.
Dominic has a knack for delivering lines with a humorous twist, lines that wouldn't be anywhere near as funny out of someone else's mouth. When Locke showed him the moth cocoon he simply curled his brow and said, "That's... wonderful, John, but...". It was obvious that a nature show was the furthest thing from his mind. It's that type of humor that makes it tough to not like Charlie, no matter what crazy stunt he's pulling any particular episode.
Neil Hopkins (Charlie's brother Liam) is one of the better recurring guest stars on the series. He's always been very comfortable in his role and his chemistry with Dominic sells the brotherly bond right from the start. That said, it always annoys me when Liam refers to Charlie as "baby brother". I don't know if that's Neil improvising or right in the script (I suspect the latter), but either way it's annoying and unrealistic.
Slight deductions for the forced celebration after Jack and Charlie emerge from the cave, but it's hard to fault the actors there given the questionable writing.

The directing, pacing, and visuals are certainly strong points of The Moth. Example include Charlie's confession (funny stuff there), a gritty Drive Shaft concert, a sunny and cozy scene in Liam's back yard, and of course the claustrophic scenes with Charlie and Jack. The visual landscape changes early and often, never allowing any scene to grow stale.
Bonus points for the end of the episode, where Kate makes a sling for Jack and sits at his side. The visual at that moment is exceptional, with a raging fire on the right of the screen and soothing streams of water off to the left.

Even the first time around I wasn't buying into the crisis, so with the island storyline it's difficult to muster any sense of nostalgia on subsequent rewatches. However, it's still interesting to see Charlie and Liam gradually switch places in the flashbacks, even though Charlie's internal battles wore extremely thin by the end of his arc.

As noted above, the visuals and acting salvage this episode to some extent. The music is also appropriately haunting and atmospheric, particularly in the opening and closing scenes.
Beyond that I just can't get past the cheese factor. This is a rare case of an episode that feels less like LOST and more like your run-of-the-mill series, one in which convenient bouts of conflict hastily give way to a predictable and saccharine resolution.