This presentation aims to illustrate substance addiction from a point of view of the psychopathological responsibility. Substance abuse has been affecting modern society for more than forty years, and the sanitary, social, economic and the psychopathological impact of substance addictions are becoming more and more disastrous. At the moment there are no signs of any decrease in the number of addicts, on the contrary, the trend continues to spread to all social classes. In all these years a psychopathological perspective has never been sistematically applied to the addiction field. A psychopathological perspective is able to achieve a deeper insight into the problem of substances addiction and thus offer new and stimulating possibilities of treatment. From this point of view a psychopathological perspective implies precise responsibility, not only for the individual working within the Health Service, but for the hole organization of the Health System itself.