Borderline personality disorder and exposure to violence are both risk factors for opioid use. While past research has identified these relationships, there has yet to be any study which investigates the potential that exposure to violence may help explain the relationship between borderline personality disorder symptoms and opioid use as a mediator. The present study used data from the Pathways to Desistance study to test these proposed relationships. Results indicated that greater levels of borderline personality disorder symptoms were associated with increased opioid use frequency. However, when exposure to violence variables were included in the model, the magnitude of this effect was attenuated by more than 20% and reduced to non-significance. These results indicate the importance of identifying and treating borderline personality disorder symptomatology and to provide increased oversight of the environments which juvenile offenders are exposed to upon reentry. Doing so may help to address the opioid crisis in the United States.