Negotiating the divide: Science, politics, and institutional boundaries in Swiss cannabis regulation

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-06-05 DOI:10.1016/j.drugpo.2025.104865

Sharon R. Sznitman , Reto Auer , Jonathan Christopher Havinga , Alessandro Casalini , Barbara Broers

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引用次数: 0

Abstract

Aim

Cannabis policy developments worldwide typically follow separate tracks for medical and non-medical use, even in jurisdictions pursuing both forms of legalization. As these parallel regulatory frameworks evolve, understanding how stakeholders negotiate and maintain boundaries between these domains become crucial for effective policy development. Using Swiss cannabis policies as a case study, this study examines how stakeholders engage in boundary work related to medical and non-medical cannabis regulation.

Methods

Thematic content analysis was conducted on qualitative interview data from 18 stakeholders involved in Swiss cannabis policy.

Results

Two distinct forms of boundary work emerged. Conceptual boundary work involved using discursive methods to legitimize medical cannabis as scientific while positioning non-medical cannabis in the social/political domain. Structural boundary work manifested through institutional mechanisms, particularly health insurance reimbursement and pharmacy distribution. Insurance reimbursement served as a key structural element distinguishing medical from non-medical cannabis. However, using pharmacies as distribution points in non-medical cannabis regulatory pilot projects was identified as problematic, potentially undermining intended boundaries between domains.

Conclusions

The study reveals that stakeholders engage in boundary work as a strategic tool to navigate the complexity of maintaining boundaries between medical and non-medical cannabis systems. Relying on scientific discourse to legitimize medical cannabis while keeping non-medical cannabis in the social/political sphere may create artificial distinctions that do not reflect the complex reality of cannabis use. Policymakers aiming to reduce blurred boundaries should carefully consider how policy elements may undermine intended separations between domains.

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协商分歧：瑞士大麻监管中的科学、政治和制度边界

世界各地的大麻政策发展通常遵循医疗和非医疗用途不同的轨道，即使在寻求两种形式的合法化的司法管辖区也是如此。随着这些并行监管框架的发展，了解利益相关者如何协商和维护这些领域之间的边界对于有效的政策制定至关重要。本研究以瑞士大麻政策为案例研究，探讨利益相关者如何参与与医疗和非医疗大麻监管相关的边界工作。方法对参与瑞士大麻政策的18位利益相关者的定性访谈数据进行专题内容分析。结果出现了两种不同形式的边界工作。概念边界工作涉及使用话语方法将医用大麻合法化为科学大麻，同时将非医用大麻定位于社会/政治领域。结构性边界工作表现为体制机制，特别是医疗保险报销和药品分配。保险报销是区分医用大麻与非医用大麻的关键结构要素。然而，在非医用大麻监管试点项目中使用药店作为分销点被认为是有问题的，可能破坏领域之间的预期边界。研究表明，利益相关者参与边界工作是一种战略工具，可以导航维持医疗和非医疗大麻系统之间边界的复杂性。依靠科学论述使医用大麻合法化，同时将非医用大麻保留在社会/政治领域，这可能造成人为的区别，不能反映大麻使用的复杂现实。旨在减少模糊边界的政策制定者应仔细考虑政策因素如何破坏领域之间的预期分离。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.