Objective: To report results from a follow-up study of alcohol, cannabis and other drugs on suicidal behavior. Method: We estimated prospective associations of substance use as a risk factor for incident suicide ideation and attempt, from a follow-up conducted in 2013 (n 1⁄4 1071) of the original Mexican Adolescent Mental Health Survey conducted in 2005. Results: Cannabis use before age 15 (ideation risk ratio (RR) 1⁄4 3.97; 95% confidence interval (CI) 1⁄4 1.43 e11.03; attempt RR 1⁄4 5.23; 95% CI 1⁄4 1.17e23.32), early onset of DSM-IV drug use disorder (DUD) among cannabis users (ideation RR 1⁄4 3.30; 95% CI 1⁄4 1.11e9.84; attempt RR 1⁄4 4.14; 95% CI 1⁄4 1.28e13.36), high frequency of cannabis use (RR for attempts 1⁄4 4.60; 1.03e20.60) and recent DSM-IV-DUD among cannabis users (RR for attempts 1⁄4 4.74; 1.09e20.57) increased the RR. For “other drug use”, significant results were found among those with high frequency use of other drugs such that they had a higher RR of suicide attempt (5.04; 1.03e24.64). For alcohol, only those who initiated alcohol before age 15 had higher RRs of suicide attempt (1.79; 1.00e3.20). Discussion: Those who used cannabis at an early age, early onset of DSM-IV-DUD, and those with heavy cannabis use and recent DSM-IV-DUD among cannabis users in the last 12-months had increased risk of suicide ideation and attempt. Drugs other than cannabis showed some of these associations, but to a lesser degree. Prevention of substance use and treatment of those already engaged in drug use, by decreasing suicide ideation and attempt, may help to prevent suicide in Mexico.