The goal of this study was to examine the relationship between suicide and substance use among completed suicides in Fulton County, Ga., from 1994 through 1998.Extensive data on completed suicides were obtained from records of the Office of the Medical Examiner. Specific characteristics of the victims who had used cocaine, ethanol, or both before committing suicide were compared across demographic groups.There were important race, sex, and age differences among the victims who had used cocaine and ethanol before committing suicide. Almost all (94.6%) of the suicide victims in whom cocaine was detected were male, 51.4% of the cocaine-positive victims were African American men, and 43.2% were white men. Substance use by teenage victims differed dramatically across ethnic lines. The vast majority (86.7%) of African American teenagers did not use either substance before committing suicide, whereas 50.0% of the white teenage victims had used one or both substances, with 41.7% of the white teenagers having used ethanol. Overall, ethanol use was much more common among white victims of all age groups.Intoxicant use preceding suicide occurred in specific age-, ethnic-, and gender-based patterns.