Fifty-eight consecutive suicides committed between 1984 and 1987 by adolescents and young adults (age 15-29 years) from an urban community were the subject of retrospective investigations through interviews with survivors and analyses of registers and medical records. Psychoactive substance use disorder in accordance with DSM-III-R was present in 47% of the youth suicides investigated, predominantly as alcohol dependence. Substance use disorder often coexisted with a borderline personality disorder or schizophrenia. Secondary depression was a frequent final factor. Dependence had developed in all females and most males. The median duration of substance use was 9 years. Substance use preceded suicidal behaviour by two years. Exposure to parental substance misuse during childhood, early parental divorce and parasuicide in the family were more frequent among subjects with substance use disorder than among other subjects. The social situation was often characterized by unemployment and legal problems. Previous inpatient care was more common than among other subjects.