OBJECTIVE: To describe the main signs and symptoms indicative of oropharyngeal dysphagia (OPD) in drug users, and to stress the importance of speech therapy in the rehabilitation of these patients. CASE REPORT: Four patients (2 men and 2 women) who used drugs. Their average age was 31 years. Substance-related disorders is a public health problem since it causes emphysema, cough, bronchitis; pneumonia; bronchial ulcers; increased incidence of schizophrenia; changes in long-term memory; and psychomotor, neurological, and cardiovascular diseases. Two patients initially had total restriction of oral feeding and received feeding by nasoenteric tube (TNE) and were classified as level 1 on the FOIS scale (Crary et al. 2005). In the clinical examination at the bedside, 2 patients had respiratory problems and 3 patients had weight loss, vocal problems, and missing teeth. In the food tests, 2 patients had cough after swallowing liquids. Because of the degree of dysphagia, 1 patient had shallow grave with a high risk of aspiration, 1 patient had OPD with a moderate risk of aspiration, 1 patient had mild OPD with a low risk of aspiration, and 1 patient had normal swallowing. After an average of 20 days in voice rehabilitation in the OPD cases, there was progression in the FOIS scale: 3 patients attained level 5. CONCLUSION: The clinical assessment showed that patients with a history of substance-related disorders can present OPD at various levels. Evaluation and speech therapy contributes to the rehabilitation of swallowing in these patients.