Summary:

This novel recasts Charles Dickens’ David Copperfield for modern day as a literary take on the opioid addiction crisis in the U.S. during the 1990s and 2000s with apparent connections to Beth Macy’s nonfiction book, Dopesick, and the eight-part TV miniseries of the same name it spawned. The author, Barbara Kingsolver, assures potential readers that having read David Copperfield is not a prerequisite for comprehending and appreciating Demon Copperhead.   

Demon Copperfield, a name that evolved naturally enough in early childhood from his birth name, Damon Fields, was born into entrenched poverty in the heart of Appalachia, Lee County, Virginia. He tells his story starting from when he drops out of his drug-addicted mother’s womb onto the floor of a rented trailer, to when as a young adult, he makes a last-chance effort at breaking loose from the life-threatening clutches of Lee County. In between, his stepfather frequently beats him bloody, his mother dies from a drug overdose, he enters foster care, attends school off and on, and works assorted jobs, many of which involve illegal, unethical, and dangerous activities. All the while he is variously abused, starved, and exploited.  

Demon shares his plight with many others in the community, and though they help each other as best they can, nearly all of them become ensnared in the same traps—drug addiction, alcoholism, unemployment, hazardous occupations, unfinished education, familial disintegration, and societal abandonment. For Demon, these conditions and experiences obliterated any vision of a future free of entrapments, let alone one of prosperity and happiness. “Here, all we can ever be is everything we’ve been. I came from a junkie mom and foster care,” is how he assessed his prospects (p. 461).  

Amidst all this suffering and bleakness, an observant and caring teacher discovers Demon’s talent in graphic arts, and he gets a peek at a path to commercial success. He has to first fight off what he knows of “Lee County being a place where you keep on living the life you were assigned” (p. 460). His story turns to this fight and onto this path. 

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The eight-part TV miniseries, Dopesick, is a nonfiction, scripted drama inspired by Beth Macy’s nonfiction book of the same title. The creator, Danny Strong, was a writer of all but one episode, director of two, and an executive producer of them all. Beth Macy served as an executive producer and contributed to the writing and updated the reporting. 

In a Kaiser Health News (KHN) panel discussion about the series with Danny Strong, Beth Macy, and three KHN staff members, Strong said his original goal “was to dramatize all this, was to create a clear record of what Purdue Pharma did.” But when Macy joined, his goal expanded “to show the victims and to hopefully redefine the stereotype of addiction...[and] ultimately our goal was to show a path forward.”

The miniseries conforms to these goals. Across the eight episodes, the drama mostly swirls around the direct connections among Purdue Pharma, one physician, one particular patient (and family), one small town in coal mining country, a Drug Enforcement Agency (DEA) investigator, and a U.S. Attorney (Western District of Virginia). In hewing to Strong’s original goal of portraying Purdue Pharma’s responsibility for igniting and fanning addiction to its product OxyContin® (oxycodone HCl), the drama reaches its climax when the company agrees to criminal charges for named executives and a financial settlement in 2007. 

Different episodes touch on other goals about the stigma associated with addiction and access to medication-assisted treatments. While Strong met his goals, he acknowledges the real-life drama didn’t end with the 2007 settlement. He previews what was to come: Purdue Pharma redoubling its sales efforts, the addiction crisis worsening over the subsequent fourteen years, and the continuing efforts to bring Purdue Pharma and its owners (the Sackler family) to their knees.

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David Sheff (Steve Carell) and Nic Sheff (Timothée Chalamet) never had a stereotypical father-son relationship, one moment sharing a joint by a Volvo 240, another speaking Klingon in a small-town café in California. The fallout of divorce proceedings and long-distance shared custody seemed to solidify their relationship further; only Nic’s summer and holiday stays in LA with his mother could separate him from his journalist father–that is, until he starts experimenting with drugs. Beginning with marijuana and alcohol, Nic eventually finds himself using meth in his teens, his intellectual precocity feeding an existential need to escape. His substance use disorder, with meth at the forefront, takes hold of his life. Over the course of roughly five years, Nic fluctuates between relapse and sobriety, resulting in two failed attempts at college, multiple instances of theft and deceit, a car chase, and a hospital admission, supposedly at Bellevue Hospital. David Sheff is all the while present to varying degrees, supporting his son in his efforts at rehabilitation while being decimated by anxiety over his child’s well-being and multiple disappearances. His concern often undermines his other responsibilities, namely being fully present in the lives of his current wife, Karen, and his two young children, Jasper and Daisy. This tension reaches its climax when Nic’s mom calls David imploring for help in getting Nic treatment. David, having reached a breaking point, refuses, saying, “I don’t think you can save people” [01:42:33]. Soon thereafter, Nic graphically overdoses for the second time and miraculously survives. The film ends with David and Nic embracing in the courtyard of a rehab facility while the second movement of Górecki's Symphony no. 3 plays in the background. Before the credits, the audience learns that, at the time of the film’s final production, Nic had been sober for 8 years.  

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