This study examined the 1-year prediction of pain killer use among a sample of at-risk youth and young adults, age 14-21. The study found that at 1-year follow-up, White youth were more likely to report using pain killers compared to African-American and Latino youth. In addition, it was found that youth, regardless of race, who lived with both parents were more likely to report later use of pain killers. In examining predictive factors for later use of pain killers, it was found that only pretest use of alcohol and marijuana were predictive of later use, while depression was found to be inversely related to later use of pain killers. These findings indicate that the significant factors of use of pain killers are previous use of pain killers, being of White ethnicity, living with both parents, and reporting low levels of depression. Data for the study were obtained from a self-report survey of at-risk youth and young adults, ages 14-21. Study participants, n=1,186, completed the surveys at baseline and at 1-year follow-up after successfully completing a substance use prevention program. The data was analyzed to determine which intrapersonal, cultural and attitudinal, and social and interpersonal factors were predictive of later pain killer use. Study limitations and implications for practice and policy are discussed. Tables and references