After having gathered and organized information on creativity, pleasure and addictions, we tried to understand the different possible interactions between artistic creativity on the one hand and substance use on the other hand. We have successively studied the possibility that substances develop creativity, that the profession of artist and artistic activities encourage the use of psychoactive substances and finally that both are part of the same process with common roots and functions. We then considered more specifically the possible therapeutic applications and in particular the interest of art-mediated therapies in patients suffering from addiction problems. Even if the studies presented lack scientific rigor, their results seem to go in the direction of a better knowledge, a better expression and a better self-esteem. It would seem relevant to develop new research and to encourage the concrete and valued development of this type of therapy in addiction care facilities.