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Introduction: The objective of the Addiction and Services Trajectories (TAS; Trajectoires Addictives et de Services) study was to identify the addiction and care pathways followed by users of substances such as tobacco, alcohol, heroin, cocaine, cannabis, and others, and to analyze how well these pathways align with their actual needs. Method: Semi-structured interviews were conducted with patient-users (P/Us) and professionals (PRs). Data collection occurred in two phases: from March to May 2019 (T1), with follow-up interviews from December 2020 to March 2021 (T2). In addition, non-participant observations were carried out within the participating institutions. Results: At T1, interviews with 34 P/Us were conducted, leading to the identification of three user profiles: “service actors,” “service spectators,” and “mixed.” At T2, among the 14 P/Us followed up, 11 maintained their initial profiles, while 4 changed, and a new profile—“service opposer”—emerged. The study highlighted motivational factors driving behavioral change and the role of environmental influences on addiction. It also demonstrated how addiction care facilities in Lorraine responded to patient needs. Patient satisfaction was closely tied to the therapeutic alliance, particularly the quality of the social relationship between users and professionals, which supported continued engagement with care. Conclusions: The study identified various patient-user profiles and clarified their positioning within the health care system. It provided a better understanding of users’ motivations and lived experiences. Future research could explore addictive behaviors from a different perspective by focusing more on life trajectories.