Prescription opiate misuse is a major public health issue, especially in rural areas. The purpose of this analysis was to examine trends in prescription opiate misuse over time in a cohort of community-based rural probationers. Participants (N=800), recruited over a four-year period, were divided into cohorts according to the year in which they were interviewed. Prescription opiate misuse increased significantly between 2001 and 2004 (p < 0.001). After adjustment for changes in demographic characteristics of the cohorts, misuse of prescription opiates was still significantly greater in 2004 compared with 2001. These data suggest changes in drug use patterns among community-based rural probationers from street to prescription drugs. Implications of the findings are discussed.