In December 2021, the Maltese government passed the Authority on the Responsible Use of Cannabis Act. This measure legalised adult recreational cannabis use, cannabis harm reduction associations (social clubs) and a new regulatory body to oversee and monitor policy change. The reform marks Malta as a key actor in the ‘second wave’ of drug decriminalisation initiatives that began in the 2010s (Eastwood et al. 2016). These parallel earlier shifts in the Netherlands and parts of the US in the 1970s. Current reforms reflect local deviations from the international drug criminalisation regime. Unlike the ‘first wave’, however, the current reforms take place within a more complex global landscape, characterised by increasing civil society engagement and reduced state capacity for coercion.

This paper investigates the political process that led to cannabis legalisation in Malta and the establishment of cannabis harm reduction associations. Based on semi-structured interviews conducted in 2022 with politicians, civil servants, academics, activists, and drug treatment professionals (N=12), our research highlights the contingent nature of the reform process. While the legalisation of cannabis represents a significant policy shift, the findings reveal that these reforms were shaped by compromises that have resulted in both progressive and problematic outcomes. A key point of resistance has been the continued influence of the UN drug control regime, which serves as a reference for conservative opposition.

Our analysis concludes that cannabis policy reform in Malta was driven by a confluence of factors, including domestic social change, civil society advocacy, political leadership, and shifting trends in international drug policy. However, these changes remain vulnerable, dependent on specific political conditions rather than a broader normative shift. The fragility of cannabis reform underscores the need for deeper institutional and societal commitment to sustain long-term change that must centre harm reduction as state policy rather than party policy.