Trends analyses were done in U.S. nonmedical prescription opioid users. From 2002 to 14, opioid disorder increased in NMPO users ages 18–34. Trends in heroin use increased significantly in 18–34 NMPO users. There was no change in opioid use disorder or heroin use among NMPO users ages 12–17. Results call to action to stop these rising trends among NMPO youth.