Switzerland tries slow-mo cannabis revolution

Switzerland, which pioneered prescription heroin and safe injection sites decades ago, is now experimenting with decriminalising recreational cannabis, with the drug now available in some Basel pharmacies.

This picture taken on March 7th, 2023 shows the ID card used by buyers during a two-year pilot for the legal sale of recreational cannabis in Basel. - Switzerland
This picture taken on March 7th, 2023 shows the ID card used by buyers during a two-year pilot for the legal sale of recreational cannabis in Basel, Switzerland. (Photo by Fabrice COFFRINI / AFP)

“This is 1,000 times better,” said Paul, a 42-year-old resident of the northern Swiss city, as he picked up a package of cannabis from his local pharmacy.

After buying his drug of choice on the street from “weird people or criminals” for the past 25 years, Paul, who asked that his last name not be published, is taking part in a pilot programme allowing him to acquire it over the counter.

“People are happy, since they for the first time can buy it legally,” pharmacist Lucas Meister told AFP, showing off a stash of colourful packages containing various dried cannabis flowers and hashish-based products.

His is one of nine pharmacies that have been chosen to take part in the two-year pilot for the legal sale of recreational cannabis.

Thousands of people applied to take part in the trial, but Paul, who mainly uses the drug to treat his depression, was among just 400 chosen.

Not encouraging consumption

Cannabis is legal for medical use in the wealthy Alpine nation, but only in extreme cases, such as pain relief for cancer patients.

Low-potency cannabis can also be purchased legally for non-medical use, but only when it contains below one percent tetrahydrocannabinol (THC) – the
component that gets recreational users high.

And while more potent cannabis is illegal, carrying up to 10 grammes of more potent cannabis for one’s own consumption is not punishable by law.

But while there are already a few ways to consume the drug without risking run-ins with police, pressure has been mounting for legalisation.

Paul smokes at home cannabis with a vaporizer during a two-year pilot for the legal sale of recreational cannabis in Basel, on March 7th, 2023.

Paul smokes at home cannabis with a vaporizer during a two-year pilot for the legal sale of recreational cannabis in Basel, on March 7th, 2023. (Photo by Fabrice COFFRINI / AFP)

In 2021, around 70 percent of the population favoured liberalising the laws, up from 58 percent three years earlier, according to the Swiss health ministry.

“We have to get out of the illicit cannabis framework, but ensure strict regulation,” said Barbara Broers, vice president of a federal commission on issues surrounding addiction.

“It is important that people have access to controlled and regulated products, but we are proposing to ban advertising and to have plain packaging, as with cigarettes in some countries,” she told AFP.

“This is not about encouraging consumption.”

Small steps

The Swiss government has opted for a small-steps approach, and authorised trials to take place over the coming decade.

In Basel, participants are aged 18 to 76, and the aim is to study “the effects of regulated cannabis sale… on mental health and on consumption behaviour,” Marc Walter, a psychiatry professor at the University of Basel and head of the study, told AFP.

So far, participants have been especially drawn to “products with a very high level of THC,” he said.

The five-gramme packs that Meister keeps in his pharmacy safe contain products with THC levels ranging from 4.5 to 20 percent.

They are priced at between eight and 12 Swiss francs ($8.70-$13) per gramme, depending on the THC level, in line with black market pricing.

The pricing level was very deliberate, according to Marc Brungger, an executive at the Swiss company Pure Production, which is producing cannabis
for the Basel trial.

“If prices are too low, people would try to resell the product, and if they are too high, they would turn to the black market,” he told AFP.

Other major Swiss cities, including Zurich, Geneva and Lausanne, are planning to launch similar trials.

‘Pure and organic’

In Basel, Paul said he is thrilled to leave street dealers behind and to finally know with certainty what he is getting: “Pure and organic cannabis”, grown in Switzerland and quality-guaranteed by the Swiss authorities.

“I want to consume cannabis, not chemicals made in China,” he told AFP, voicing horror at the arrival on the street of synthetic cannabinoids – laboratory-made molecules that mimic the THC effect.

The marketing specialist said it was a shame Switzerland had not taken a more direct route to legalisation, as in some US states, Canada and Uruguay.

But Walter said he was happy “Switzerland has chosen another route”.

“As a scientist, I prefer that.”

Frank Zobel, head of Addiction Switzerland, agreed, pointing out that taking things slow and steady to see how the population responds was a very Swiss approach.

That model proved itself in the 1990s, he said, noting how Switzerland had slowly introduced prescribing heroin for medical use.

“There too, there were four years of pilot trials, and today it is a treatment that is covered by medical insurance,” he said.


Member comments

Log in here to leave a comment.
Become a Member to leave a comment.
For members


ANALYSIS: Do the Swiss really want ‘cheaper’ health insurance?

Calls for less expensive heath insurance premiums have been increasing in Switzerland in recent months. But do the people really want that?

ANALYSIS: Do the Swiss really want 'cheaper' health insurance?

The rising cost of Switzerland’s obligatory health insurance has been fueling much debate among the politicians and public alike.

Various measures to cut the rampant costs have been proposed, ranging  from tying premiums to income and abolishing the current private system in favour of a public, government-run one similar to the schemes in place across Europe.

The reason for this radical change is that “with a single player, it will be easier to maintain decent prices,” according to MP Baptiste Hurni, who is behind this proposal.

READ ALSO : Would people in Switzerland benefit from a government healthcare scheme?

In the wake of the announcement earlier this week that rates will rise by 8.7 percent on average, calls for the public option — and cheaper health insurance — have been increasing.

Everyone agrees that cost-curbing reform of the healthcare scheme is urgently needed, but do the Swiss really want to scrap the private system and replace it with a ‘cheaper’ government-run one, or is it just a reflex reaction to bad news?

Competition and free choice

The idea of the government managing the healthcare system is not exactly new in Switzerland; it had been brought up in the past when insurance rates had gone up.

Two referendums were held on this issue in the past 16 years, and both times the idea of a public health insurance scheme was turned down: by 71 percent in 2007 and by 61.5 percent of the votes in 2014.

Both times, the decisions were based on practical and rational, rather than purely emotional, considerations.

As Swiss media explained it at the time, voters “noted the negative consequences of a public fund, citing in particular the absence of competition, the loss of free choice, and a certain unease with increased state intervention in the health sector.”

Additionally, “voters were not convinced that the new system would have been able to reduce health insurance premiums” — the argument that is still being raised today. 

Another argument that swayed the voters away from the government scheme is that the private insurance system provides a higher quality of services —including better access to specialists and shorter wait times for medical procedures than in countries with the public system.

According to a survey by the Organisation  for Economic Cooperation and Development  (OECD) on how long patients in various countries typically wait for an appointment with a specialist, the share of people in Switzerland waiting a month or more is 23 percent, compared to 36 percent in France, 52 percent in Sweden, and 61 percent in Norway.

OECD statistics also show that Switzerland has among the shortest waits for medical tests and procedures.

And there is more.

The Swiss are actually very happy with their private system.

A survey conducted in 11 countries by the US-based Commonwealth Fund Foundation showed that 88 percent of respondents rate the overall performance of Switzerland’s health system as ‘good’ or ‘very good’, putting Switzerland in the first place.

It is therefore doubtful that the Swiss, who are accustomed to (you may even say ‘spoiled’ by) the current system of healthcare, will be happy to switch to a lesser one.

As a forum commentator in one of the local newspapers pointed out “you will find faults in our system until you go abroad and see how good we really have it.”

And an important point was made by another forum user: “We all want high-quality health care and all the latest technology, but we should realise  this costs money and doesn’t come cheaply.”

No revolutions, please

Referring to the idea of replacing the present system with the public one, Health Minister Alain Berset said during a press conference this week that Switzerland has a “very good health system” and doesn’t need a radical overhaul.

“With the exception of 1848 [a year of political reform in Switzerland], I have never been a supporter of revolutions,” he added. “There is no need for one now.”

So what is the solution to soaring costs?

Instead of drastic changes, Berset said the current system, which has proven its worth since it was first introduced in the mid-1990s, should undergo cost-cutting measures.

Among the steps being debated are lower drug costs, more use of generic medication (which is less expensive than brand-name drugs), better transparency of costs billed by hospital and doctors; as well as fewer procedures for which there is no strict medical need.

READ ALSO: How Switzerland wants to cut soaring healthcare costs