Social forces shaping evidence production: A study of the swiss cannabis pilot trials.

Abstract

Aim The evidence-based policy paradigm has been criticized for poorly representing drug and other health policy processes, with evidence showing various social forces influencing knowledge translation. However, less research has examined the social forces influencing knowledge production. Applying a social constructivist lens, this study investigates how politics, power, economics, philosophy, and discourse influence the evidence generating processes related to drug policy.Methods Using Swiss cannabis pilot trials as a case study, thematic content analysis was conducted on qualitative interview data from 18 stakeholders, including scientists, policy makers, pharmacists, physicians, cannabis producers, and current and former employees of the Swiss Federal Office of Public Health.Results The study reveals how social forces collectively shape scientific evidence generating processes, with political imperatives and stakeholder interests often taking precedence over purely scientific considerations. Contrary to the presumed opposition between positivist and interpretivist stances, informants demonstrated a commitment to both, dedicating themselves to positivist research agendas while highlighting the influence of harm reduction discourse on the pilot trials.Conclusions The Swiss cannabis pilot trials illustrate how social forces can shape the production of policy-relevant evidence, transforming evidence-based policy into policy-based evidence. Asymmetries in actor resources and power, along with the adjustment of evidence production to align with contextual realities, play significant roles in this process. Recognizing the complex social dimensions of evidence generating processes is crucial for a more reflexive and power-sensitive understanding of drug policymaking.