This study explored Appalachian school counselors' experiences responding to the ongoing opioid epidemic within their respective school communities, an underexplored topic in educational and school counseling research. In response to this gap, we utilized a transcendental phenomenological approach to explore the lived experiences of five school counselors working in communities within the Appalachia region of the United States. Three themes emerged through the individual interviews: contextual factors, school counselor impact, and preparedness. Overall, the study is a critical first step in better understanding school counselors' positioning in school communities adversely impacted by the opioid epidemic. Moreover, these findings support the need for school counselor and school community training centered on opioid use, trauma, trauma-informed schooling, and addiction. Additional implications are offered, along with limitations and areas for future research.