Kingsolver does not come at the subject of the book casually. In an interview with the Financial Times (January 6, 2023), she reveals her “pre-verbal attachment” to Appalachia. After moving away in early adulthood, she returned later in life to the Appalachian town of Abingdon, Virginia, putting her in close proximity to Lee County for the last twenty years. She has witnessed the devastation the opioid crisis has caused and recounts how in her town, “everyone has friends who were directly impacted. A huge percentage of our kids are not being raised by their parents because their parents are incarcerated or addicted or dead...There’s a generation of kids growing up here with immense trauma.”  

Because of the disproportionate impact the opioid crisis exacts upon the youth of the area, Kingsolver has them tell the story, “the lost boys and lost girls, this generation of kids that feel like nobody wants them.” She flips the usual narrative of nonfiction and investigative works that puts the forces driving the crisis—opioid manufacturers, distributors, and providers—at the center and the victims on the periphery. With the victims at the center, Kingsolver offers a view of the opioid crisis in Appalachia from ground zero. We read about the daily lives of Demon and those in his life, like Dori, Angus, Fast Forward, Maggot, Emmy, June, and Hammer among many others, and what made them particularly susceptible to opioid addiction—how the drugs found them. We do not read much about the forces that fueled the opioid crisis or the government agencies and legislatures that failed to stop it.  

With the story centered on the victims, the threat of opioids becomes another of many threats to the lives and prospects of children in the area. But threats they are, and Kingsolver makes the presence of these threats known in subtle ways; they lurk, they stalk, they strike. The presence of a Purdue Pharma sales representative in the area is only mentioned when someone notes that the sister of Demon’s friend, a nurse, is dating him. She parrots his claims in general conversation about OxyContin safety. “I can show you the package insert,” she tells her reluctant father in need of pain relief” (p. 243). Mention is made of a financial settlement with Purdue Pharma, but only that chances are “not a dime of it ever getting back here” (p. 529). 

But the novel is not disconnected from nonfiction accounts of the opioid crisis. In fact, it expands on them, providing a fuller understanding of the daily lives of those who are affected. In particular, the novel contains several throughlines to Dopesick. Like Kingsolver, Macy resides in the area where Demon Copperhead is set, and has similarly witnessed and studied the destruction the opioid crisis has wrought there. Indeed, the first settlement with Purdue Pharma as detailed in Dopesick was led by the U.S. Attorney General’s office in Abingdon. They both drew from similar local sources, for example, Dr. Art Van Zee, who was among the very first health care professionals who sounded alarms of the opioid crisis and led efforts to counter it.  

The novel works well on its own as a compelling story, but it can also serve as a companion to nonfiction books, documentary films, and investigative reports of the opioid crisis with the expanded view it generates of how individual lives are affected in the midst of all else that affects them. More is to be known about the opioid crisis in the U.S. from reading both Dopesick and Demon Copperfield than either alone, illustrating how literary fiction can add to the understanding of real and contemporary issues important to the general public.