In general, much has been written on women's patterns of drug use and the varying factors that impel them into addiction and subsequently into recovery. However, there is a paucity of information on rural Appalachian women and how they make meaning of their recovery processes. Drawing on data collected through informal interviews this article explicates dimensions of the various strategies 25 rural women develop and apply as they shift from using alcohol and/or drugs to their nonuse of such substances through a consideration of their self-change processes: the disgusted self, the aware self, the alternative self, and the stable self. Furthermore, with little access to treatment in this region, data show that participants compensated for that within their own cultural contexts: through the use of family, church, friends, work, school, and self-help institutions such as Alcoholics Anonymous and Narcotics Anonymous. I conclude with a discussion of the implications of these strategies for understanding rural women as they manage recovery processes.