New Study Reveals Unequal Power Dynamics in the Shaping of Sweden´s Drug Policy
The majority of stakeholders perceive that they have opportunities to influence Sweden´s drug policy. However, many people experience that people who use drugs cannot get their voices heard. This is demonstrated by a new study from the Department of Public Health Sciences Stockholm University.
This study is the first systematic analysis of how stakeholders try to influence drug policy and how they perceive their opportunities to influence drug policy formation. Based on 38 interviews with national-level stakeholders – including politicians, professionals, NGOs, and PWUD representatives – the study found that resources and access to political arenas matter more than interest alone.
Political will is necessary to ensure more equitable stakeholder involvement in drug policymaking.
The researchers found that, in order to try to influence drug policy, nearly all stakeholders rely on a mix of direct strategies, such as formal consultations, and indirect strategies, like networking or shaping public opinion. A majority of the stakeholders reported that they were using both direct strategies and indirect strategies.
Those with resources, such as economic resources and social contacts, perceived having far greater opportunities to influence.
Stakeholders use informal contacts
Many stakeholders denied using informal ways to influence, such as informal contacts with powerful actors. Still, the majority acknowledged the existence of informal ways to try to influence drug policy. Informal contacts can be seen as an important resource among stakeholders, facilitating access to political arenas and enhancing influence.
“Power outweighs interest. While many groups care deeply about drug policy, well-resourced actors dominate the process when they seem to have better opportunities to influence drug policy”, says Tuulia Lerkkanen, PhD student at the Department of Public Health Sciences at Stockholm University.
Institutionalised norms are guiding principles
For example, people who use drugs (PWUD) and their families are almost excluded from the policy shaping. Although recent initiatives, such as the Swedish Government´s Comorbidity Inquiry 2021, was seen as a good example of including PWUD voices, these efforts were often described as superficial or symbolic.
In this context, Sweden’s consensus-driven political culture also plays a role. The study reveals that there are informally institutionalised norms that guide how to express one’s opinions, advising stakeholders to not come across as either “drug liberal” or “too conservative”.
A slow shift might be on the way
While the study shows that genuine policy change has so far been limited, there are signs of a slow shift. Growing acceptance of harm reduction measures and the involvement of PWUD in recent inquiries may signal a move toward greater recognition.
Still, the results also indicate that the extent of a stakeholder’s resources along with their support for the current restrictive drug policy can be identified as factors enhancing stakeholders’ policy salience in the drug policy.
A need for broader inclusion
The authors of the study argue that, in order to achieve a more balanced policymaking shaping future drug policy based on democratic principles, political efforts to broaden inclusion is required.
“Political will is necessary to ensure more equitable stakeholder involvement in drug policymaking. According to the stakeholders that I interviewed, this means that politicians that have the greatest opportunity to influence also bear a responsibility of involving different groups in drug policymaking.”, Lerkkanen says.
Håkan Soold
Facts
The study Stakeholders’ opportunities and attempts to influence drug policy in Sweden was published recently in the scientific journal Drugs: Education, Prevention and Policy.
The study is a part of Lerkkanen’s doctoral thesis project that examines stakeholders’ interest and influence in Swedish drug policy.
Besides Tuulia Lerkkanen, the following two researchers contributed to the study: Jessica Storbjörk and Lena Eriksson, researchers at the Department of Public Health Sciences at Stockholm University.
Last updated: October 13, 2025
Source: Department of Public Health Sciences