Born to a teenage single mother in a trailer in Lee County, Virginia, a red-haired boy nicknamed Demon Copperhead narrates his own battering progress through the wreckage of contemporary Appalachia. When his mother dies of an overdose he is passed through a callous foster system, set to labour on a tobacco farm, half-starved and half-raised, until football and the wary kindness of Coach Winfield offer a foothold, before a field injury and a doctor's prescription pull him into the opioid dependency devouring his region. Kingsolver reworks Charles Dickens's David Copperfield beat by beat, transposing its orphan's picaresque onto the pill epidemic, and Demon's furious, funny, wounded voice turns a social catastrophe into intimate testimony. As addiction claims those he loves, including his girlfriend Dori, the novel presses hard on how poverty and profit conspire to consume children. It is a book about the institutions that fail the rural poor, and about the stubbornness required simply to keep telling your own story.