Substance use in adolescence relates to other problems such as involvement in violence and mental/physical health problems. This study aimed to identify substance use patterns in a considerable sample of Brazilian adolescents and to estimate the magnitude of the relationship between each pattern and violence involvement indicators, as aggressor and/or as victim, and of mental and general health. The data analyzed were collected from 6702 schoolchildren, within the scope of the National Survey of School Health, employing latent class analysis for reports of alcohol, tobacco, marijuana and crack cocaine use. The five groups identified were compared regarding their involvement in violence and mental and general health aspects. Abstainers (18%) would neither make use of substances, nor be involved in violence or display health problems. Drinkers (26%) would tend to only make use of alcohol, but would not display the other problems either. Conventional Drug Users (28%) would tend to make use of alcohol and tobacco or alcohol and marijuana and would also be involved in violence, but would not display health problems. Polysubstance Users (23%) would tend to make use of alcohol, tobacco and marijuana and would be more frequently involved in violence. Hard Drug Users (5%) would tend to make frequent use of all substances in addition to also being more involved in violence, both as aggressor and victim, and would display mental/general health problems. Our findings reveal different levels of problems and reinforce the importance of varied prevention/treatment policies in order to meet specific demands.