Stories from doctors, nurses, and therapists dealing on a daily basis with the opioid crisis in Appalachia should be heartbreaking. Yet those told here also inspire with practical advice on how to assist those in addiction, from a grass-roots to a policy level. Readers looking for ways to combat the crisis will find suggestions alongside laughter, tears, and sometimes rage. Each author brings the passion of their profession and the personal losses they have experienced from addiction, and posits solutions and harm reduction with positivity, grace, and even humor. Authors representing seven states from northern, Coalfields, and southern Appalachia relate personal encounters with patients or providers who changed them forever. This is a history document, showing how we got here; an evidenced indictment of current policies failing those who need them most; an affirmation that Appalachia solves its own problems; and a collection of suggestions for best practice moving forward.