During the 24-year study, 159 cases of definite suicide and 38 cases of likely suicide were noted. The suicide rate increased markedly among youth during the study period, particularly among white males between 15 and 19 years of age, and was not due to changes in classification procedures over time. The suicide rate by firearms increased much faster than the suicide rate by other methods. The proportion of suicide victims who had detectable blood alcohol levels rose from 12.9 percent in 1968-1972 to 46 percent in 1978-1983. Suicide victims who used firearms were 4.9 times more likely to have been drinking than were individuals who used other suicide methods. The availability of firearms and the increased use of alcohol by young people may have significantly contributed to the increased suicide rate. 28 references and 4 tables