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Drug use studies have mainly examined risk management among vulnerable populations that are commonly categorized by their risk-taking behavior. They have not, however, investigated functioning users’ perceptions of risks and harms. The current study attempts to fill this gap by examining how functioning people who are in the process of building their careers or family lives perceive and manage the risks and harms of drug use. We interviewed 29 Israelis who use drugs, dividing them into two different groups: the first comprised 16 regular or previously regular cannabis users and one cocaine user who didn’t describe themselves as problematic users and were not in treatment; the second comprised 13 regular users of cannabis, methadone, MDA, and cocaine who described themselves as problematic users and were in treatment. We conducted content analysis of these interviews which refers to both risk management and harm management and defined three different options. The first option refers to participants who described feeling no risk or harm from their drug use. The second focuses on participants’ perceptions of the subjective risks and their ability to manage them via the following domains: social relationships, profession, social status, finances, and health and lifestyle. The third deals with participants who recognized the harms in the domains of family and social relationships, health, and daily functioning. An understanding of these three options could help counselors when encountering such users.

Drug risk perception and risk management strategies among Israeli functioning drug users: a qualitative exploration