This study examined how non-medical prescription opioid use (NMPOU) among youth aged 12–24 is linked to their health, social needs, and use of services within an integrated youth services network in British Columbia, Canada. Data from over 6,000 youth showed that 4% reported recent NMPOU. Youth who used prescription opioids non-medically were more likely to report poor physical health, mental health challenges, polydrug use, and recent exposure to violence. Despite these greater needs, their use of services was similar to youth who did not report NMPOU. The findings suggest that integrated...