Substance use, along with mental health problems, is often associated with fatal and non fatal suicide attempts.

The type of drug (Opiates, cocaine and sedatives), the severity of use (mix of substance, doses…) and the co- occurrence of alcohol and drug consumption, influence the risk of suicide.

Severe brain damage may arise as consequence of suicide attempts and the occurrence of multi substance abuse may worsen outcome.

The aim of the present paper is to explore the clinical picture of three patients with drug addiction (2 males and 1 female) who survived a substance related suicide attempt.

Due to the resulting anoxia, they suffered a brain injury for which they were admitted in a rehabilitative centre.

The time gap between the injury and the admission was very variable and allowed us to explore also chronic conditions.

We examined neuropsychological functioning with MMSE and LCF (Level of Cognitive Functioning) and functional impairment with FIM (Functional Independence Measure) at the time of admission and at follow up. We described also personality and psychological traits deriving from MMPI and Millon Multiaxial Clinical Inventory.

Reported data show that brain damage after anoxia in suicide attempts by substances intoxication can result in severe motor and cognitive impairement.

In a long term follow up, the evolution of clinical pictures is very different and in the chronic phase psychopathological personality traits still can be observed.

In all of them, the global outcome is severe and non-reversible disability, needing continuous neuropsychopharmacological treatment and with extremely impaired quality of life.