Barbara Kingsolver’s literary honours range from the National Book Prize of South Africa to the PEN/Faulkner Award.

On May 8, 2023, she added a Pulitzer Prize to her accolades.

Her winning novel, Demon Copperhead, is more than just a reimagining of Charles Dickens’ David Copperfield. Casting an opioid-addicted Appalachian orphan as her protagonist, Kingsolver sheds new light on one of America’s greatest health crises.

Understandably, the Covid-19 pandemic eclipsed media coverage of and national concern over the opioid epidemic; nevertheless, opioids remain a massive public health problem, and I think the author’s attention to it is both welcome and necessary.

In taking up the topic, she joins artists with ties to Appalachia, such as bluegrass guitar phenom Billy Strings, the late singer-songwriter John Prine and photographer Stacy Kranitz, all of whom have used their art to highlight the ravaging effects of these drugs on their region.

How artists can reclaim a place

As an American Studies professor who teaches courses on both country music and images of rural America, I see this groundbreaking work through the lens of cultural geography, which explores the relationship between culture and place.

A region can inspire unique forms of art, music, literature and architecture, and the work of geographer Edward Soja helped show how this work can push back against stereotypes.

In 1996, Soja published Thirdspace: Journeys to Los Angeles and Other Real-and-Imagined Places.

In it, he argued that stereotypes of a region’s people and landscape could lead to damaging politics and policies. For example, outsiders’ views of “the inner city” as hotbeds for poverty, crime and broken families led to the implementation of racist public housing policies in the 1960s.

Soja’s book was a call to arms for artists and the marginalised: In what he called “thirdspace” – a place that exists at the intersection of the real and the imagined – they can reclaim and reframe visions of their region, showcasing different identities and experiences.

Appalachia is a region that, for generations, has been subjected to economic oppression, classist stereotyping and environmental and medical recklessness. The pumping of opioids into rural communities represents just another chapter in this story of exploitation.

Yet artists and writers like Kingsolver are able to show that the people in the region are more than just backward, powerless victims – that they are complicated people with the same goals, longings and fears as the rest of us.

More than an addict

Kingsolver, who was raised in rural Kentucky and who currently resides in Virginia, had a keen vision for Copperhead. She weaves the history of the economic fallout from the tobacco industry and coal mining into her protagonist’s backstory.

Her central concern, though, was always the opioid crisis.

As she told The New York Times in October 2022, “I wanted to say, ‘Look, it’s still here, and this got done to us and we didn’t deserve it.’”

That’s the story of Demon’s life. An orphan who experiences poverty, an abusive foster home and social isolation, he finds freedom and glory on the football field, only to experience a devastating knee injury.

Pressured by his coach and the townspeople to play through his pain, he blindly takes the OxyContin that the local Dr Feelgood prescribes, only to find himself crippled physically, psychologically and emotionally by his addiction.

And yet, through all of that, Demon is much more than his habit. Kingsolver foregrounds his humanity, his humor and his potential for goodness in a way that makes him more than “just an addict.”

In doing so, Kingsolver uses her connection to the region, her empathy for its residents and her awareness of stereotypes about Appalachians and addicts to avoid what could have easily been a reductive portrayal. Instead, she crafts a realistic and still-not-despairing vision from the inside.

This approach – an example of Soja’s thirdspace – is, in my view, the most powerful tool that artists have at their disposal to counteract the impulse to move on from grappling with this ongoing epidemic.

Filling the void

What Kingsolver does in prose, Billy Strings and John Prine do in song.

Strings, whose breakout hit, Dust in a Baggie, is a portrait of methamphetamine addiction, takes on opioids in Enough to Leave, a track from his album Home.

Written to commemorate two friends who overdosed on fentanyl-laced heroin within the same week, the song is a haunting evocation of grief for those left behind when addiction takes its toll:

Enough to kill ya, enough to put you down
Seems like every way you turned was like a hard wind comin’ down
Enough to leave me, enough to leave me here
And though the room is empty now I can almost feel you near...

The same is true for Prine’s Summer’s End, a track from his last album, 2018’s The Tree of Forgiveness.

The video for that song, directed by West Virginia filmmakers Kerrin Sheldon and Elaine McMillan Sheldon, portrays an ageing grandfather and his young granddaughter going about the mundanities of daily life in the wake of their daughter and mother’s death. A single frame depicts a news headline about the opioid crisis, illuminating the source of their suffering without overshadowing the regularity of their routines.

The video brings to mind a line from Samuel Beckett’s 1953 novel The Unnamable: “You must go on. I can’t go on. I’ll go on.”

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Upending a theory of ‘genetic decline’

Words, music and pictures – all have become powerful tools in this thirdspace reading of opioid-afflicted Appalachia.

Like the Sheldons, Kentucky-born photographer Stacy Kranitz offers gritty, complex and beautiful photographic portraits of Appalachia.

She has written about how she wants her work to provide a corrective to the negative portraits of Appalachia penned by Kentuckian Harry Caudill and New York Times reporter Homer Bigart in the 1960s.

Caudill, who emphasised the economic exploitation of Appalachia, also came to embrace William Shockley’s theory of dysgenics, arguing that “genetic decline” among the people of Appalachia played a contributing role in the perpetuation of their suffering.

Their work brought Appalachia to the Johnson administration’s awareness. But it also amplified the national perception of the region and its people as backward, helpless and ripe for exploitation.

Kranitz’s engagement with Appalachia – particularly her refusal to let Caudill’s stereotypical views of its inhabitants as backward and regressive stand – offers a thirdspace revision of the region and its residents. Her series As It Was Given to Me juxtaposes a burning cross at a Klan rally with an image of a lovely, innocent girl holding a lit sparkler. Unafraid to illustrate the ugliness of the region, Kranitz is equally insistent on finding its beauty.

Like these artists and musicians, Kingsolver set out in “Demon Copperhead” to wrestle with the region’s complex history and its current social ills.

In that, she succeeded.

Hopefully the Pulitzer committee’s recognition of the novel will lead others to not only educate themselves about Appalachia, but also participate in the work needed to undo the damage that these drugs have done – and continue to do.

William Nash is Professor of American Studies and English and American Literatures, Middlebury.

This article first appeared on The Conversation.