Substance use among helping professionals: rationalization and negotiation of professional identity

Introduction Given the scarce research on the drug use situation among helping professionals and the existing organizational structures that may affect them, this study explores how helping professionals in Hong Kong make sense of personal drug use and negotiate professional identity. Methods Narrative, semi-structured interviews were conducted with 15 helping professionals. Interviews were conducted in Cantonese, transcribed verbatim, and translated into English, prioritizing semantic equivalence for colloquialisms. Culturally specific terms were retained in parentheses with brief explanatory notes where needed. An interpretivist, reflexive thematic analysis was undertaken using NVivo. Results Drug use served coping, social and/or sexual functions. Participants managed cognitive dissonance through compartmentalization, normalization and critiques of illegality, and by reframing lived experience as strengthening rapport and credibility with clients. Conclusion While their drug use may not have directly caused impairment, their rationalization of behavior instead of disclosing it and seeking professional support suggests underlying organizational and institutional issues. Anticipated workplace sanctions and professional impairment discourse fostered concealment and delayed help-seeking. Therefore, rather than adopting a zero-tolerance governance approach, establishing clear practice-related thresholds and providing confidential, harm reduction-informed workforce supports may better protect these professionals’ wellbeing and ensure service quality.