Demon Copperhead by Barbara Kingsolver review – Appalachian saga in the spirit of Dickens

Last year in the US, opioids were involved in more than 80,000 overdose deaths, representing yet another hike in an epidemic that began in the mid-1990s and shows no signs of abating. Fury at the now well-documented role big pharma played in its creation ripples through Barbara Kingsolver’s charged new novel, a hillbilly coming-of-age saga that seizes from its opening line.

“First, I got myself born,” announces its protagonist, Damon Fields – no mean feat given that his addict mother, little more than a child herself, is lying passed out among her pill bottles in a trailer home in Lee County, Virginia.

He grows into a wild boy with red hair inherited from the dead father he never knew, and before long the nickname “Demon Copperhead” has stuck. “You can’t deny, it’s got a power to it,” he observes, and so does his voice, summoning in its singularity the likes of Huck Finn and Holden Caulfield while hailing from a very different demographic.

For this is a novel that testifies to the experience of some of the earliest casualties of the opioid crisis, in particular the hollowed-out communities of Appalachian America, who tend to feature in the wider culture solely as the butt of jokes – they’re moonshiners, hicks, rednecks. It’s an intensely personal mission for Kingsolver, who grew up in Kentucky versed in a language that, as she puts it in her acknowledgments, “my years outside of Appalachia tried to shame from my tongue”.

Her boy hero spends his earliest days inseparable from his best friend, “Maggot”, playing in the woods and messing around in creeks lined with mud “that made you feel rich – leaf smelling, thick, of a colour that you wanted to eat”.

They’re ragged, hungry kids for whom Bible stories are as fanciful as superhero comics, so nature provides just about the only salvation going, despite rumours of venomous copperhead snakes locally. Demon will need every lungful of green air that he can get because a thug of a stepfather is about to overturn his world, and a stolen OxyContin prescription will knock his mother off the wagon soon after.

Dire experiences in the “foster factory” follow, compelling Demon to track down a long-lost grandmother who persuades the local high-school football coach to take him in. He becomes a star player, but his tale’s linguistic dynamism is up against the dogged fatalism of its plot, and when he’s injured in a game and the pain pills are doled out, a sorry outcome surely looms.

With its bold reversals of fate and flamboyant cast, this is storytelling on a grand scale – Dickensian, you might say, and Kingsolver does indeed describe Demon Copperhead as a contemporary adaptation of David Copperfield. That novel provides her epigraph: “It’s in vain to recall the past, unless it works some influence upon the present.”

The words signal Kingsolver’s avowedly political intent as an author – one that smothered the creativity of her last novel, 2018’s Unsheltered, but is for the most part more subtly integrated here despite the book’s long list of righteous campaigns. They crystallise, too, Demon’s quest: still barely into adulthood by the novel’s close, he has been trying to pinpoint where things started to fall apart for him.

Should he even be held accountable for bad choices after the start he had? Maggot’s Aunt June, a homecoming queen turned crusading nurse, insists not, but as Demon discovers, owning his story – every part of it – and finding a way to tell it is how he’ll wrest some control over his life. And what a story it is: acute, impassioned, heartbreakingly evocative, told by a narrator who’s a product of multiple failed systems, yes, but also of a deep rural landscape with its own sustaining traditions.

• Demon Copperhead by Barbara Kingsolver is published by Faber (£20). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply