In 2008 the school dropout rate in Central Appalachia was at 27% and the drug problem was epidemic. An investigation centered on a sample of Central Appalachian residents who had been discharged from the local outpatient clinic for opiate dependency revealed insights into their educational experiences and an understanding of drug dependency and the culture of the region. Bandura's social learning theory, Glasser's reality therapy, and Gay's concept of a culturally responsive curriculum served as the theoretical base of this inquiry. The research questions that guided the study addressed perceptions about educational backgrounds, influences, opportunities, challenges and goals. This study employed a qualitative methodology and 12 Central Appalachian residents served as a purposeful sample. The instrument used was a semistructured, in-depth interview of 12 open-ended questions. Data analysis employed the research questions to classify the data which allowed the categories to hold together in a significant way. Key findings indicate that Central Appalachian residents (a) quit school at 16 and do not value formal education, (b) are influenced by the culture of the region in regard to education, (c) find consolidation challenging, (d) find opiate dependency challenging and (e) have no formal educational goals for themselves or for their children. The results of this inquiry established a benchmark in regard to the meaning of formal education in this area and served to inform practitioners about the need for changes in pedagogical techniques that would be more culturally responsive to the needs of at-risk Central Appalachian students. The study outcomes imply that if these challenges are not addressed, Central Appalachian students will continue to be alienated, continue to struggle, and continue to fail. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]