The increase of harm reduction strategies in North America indicates some major transformations in the field of drug use regulation. Having drawn attention to the similarities between harm reduction strategies and risk management principles, we are proposing a theoretical representation that combines these two intervention levels under a larger model that supersedes the restrictionist approach: the managerial model. We also want to highlight that neutralization and surveillance imperatives produced by risk management rhetoric may overlap the harm reduction approach. The contamination of a level by another could lead to a stigmatization of drug users, instead of offering humanistic services as in the harm reduction strategies.