In this paper, I explore risk factors for opioid use and abuse among juvenile justice system-involved adolescents convicted of a serious offense; a group known to experience high rates of substance abuse and dependence. Using the Pathways to Desistance dataset, I assess whether risk factors for substance use that includes opioids are distinct from the risk factors for other illicit substance use that does not including opioids (non-opioid substance use). I also explore how, if at all, the motives and patterns of opioid use are distinct for male and female adolescent offenders. I identify older age, white race, and clinically significant mental illness as significant risk factors for substance use including opioids relative to non-opioid substance use. I do not find any distinct risk factors for adolescent females’ opioid use relative to their male peers.