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The courts in the United States have been criticized for allowing extra-legal factors (e.g., race, socio-economic status, etc.) to influence judicial decision-making. In particular, the 1980s marked a period in which racial minorities adjudicated for drug crimes were subject to longer and more punitive sentences. The most recent drug problem facing this nation has been the illicit diversion and use of prescription drugs. Although this drug epidemic is similar to previous ones, there are a number of factors which distinguish it – mainly the pathways of diversion (e.g., friends, family, pain clinics) and the type of user (e.g., white, middle- to upper-class). Given the history of extra-legal factors and their influence on sentencing outcomes for drug-related offenses, along with the differing profile of the supplier/user of prescription drugs, the present study seeks to examine whether extra-legal factors also have an influence on crimes associated with this drug type. An analysis using a sample of offenders sentenced in federal courts was used to examine the influence of both legal factors (e.g., criminal history and severity of offense) and extra-legal factors on sentencing outcomes. Findings from this study present insight into the current prescription drug epidemic and their influence on judicial decision-making.