Nonmedical use of prescription drugs has become a serious social problem among American youth. Two general categories of motives for the nonmedical use of prescription drugs include self-treatment and recreational use. This study assesses differences between nonmedical prescription drug users based on their self-reported motivation for using prescription drugs. Data come from more than 11,000 11th grade students in Delaware public schools. Analyses indicate significant differences in prevalence, correlates, and consequences on nonmedical use of prescription drugs based on motivation for use. Analysis reveal that, among those students who reported non-medical use of prescription drugs, those who are using for recreational purposes are significantly more likely to engage in other risk behaviors, such as using other illicit substances and engaging in violent behavior.