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The movie where Matthew McConaughey gets scary-skinny has finally arrived, and it’s not just about the weight loss. Yes, “Dallas Buyers Club” is classic “Oscar bait,” and falls into some of the common traps of exploiting a true story. But it’s also lively, funny and scary, bristling with the most compelling drama of all: the grasping will to live and make it count.

Jean-Marc Vallee’s film, scripted by Craig Borten & Melisa Wallack, opens in 1985, as the world awoke to Rock Hudson as the sudden and gaunt celebrity face of AIDS. McConaughey plays Ron Woodruff, a hard-charging electrician and rodeo cowboy first seen plowing women in the shadows before bull-riding with money riding on how long he can hold on. It’s a canny entree into the story: When Woodruff sprints away after losing his bets, he’s been swiftly established as an all-around reckless character, his sexual recklessness a possible cause of his looming AIDS diagnosis (drug use, as we learn, is another).

Faced with a doctor (Denis O’Hare) who tells him, “Frankly, we’re surprised you’re even alive,” a T-cell count of nine, and “30 days left to put (his) affairs in order,” Woodruff allows himself to muse, “Gotta die somehow,” before fiercely rooting out his limited options. Woodruff gets wind of a human trial for AIDS-combating drug AZT, but he’s denied access. “Screw the FDA,” he blusters. “I’m going to be D.O.A.”

Though AZT is “the most expensive drug ever marketed,” Woodruff puts his scamming, self-preserving instincts to use and gets his hands on a supply, washing his first dose down with a swig of beer chased with a line of coke. Thus begins an education with a steep learning curve and sky-high stakes, and in the process of literally saving himself (long outliving his diagnosis), Woodruff necessarily creates a drug pipeline that he winds up sharing with his new community of fellow patients.

Like the long, offensive history of black stories told through a white protagonist, this one can be seen as a presumptively gay-centric story an AIDS crisis drama told through a straight protagonist whose homophobic assumptions are challenged by, oh boy, a drug-addicted transgender woman named Rayon (Jared Leto, in an admittedly mesmerizing performance). Though based on a true story, “Dallas Buyers Club” plays it fast and loose in ways that arguably diminish a more fascinating truth.

Still, on its own terms, the film doesn’t lack for potent drama. Along with the showy (reportedly 50-pound) weight loss that leaves him a shell of his former self, McConaughey gets a meaty character arc: a good-ol-boy, just this side of despicable, redeemed at first only by his will to live, who learns to love his unlikely gay bedfellows as he fights off antagonistic government agencies (the FDA and DEA) and obstructionist doctors (Jennifer Garner playing one of the good ones). It’s a hero’s journey that compels us in spite of ourselves, empowered by an actor at the top of his game.

Rated R for pervasive language, some strong sexual content, nudity and drug use. One hour, 57 minutes.

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