Democratically organised societies have to find ways how to proceed when in need of a reformulation of strategies in face of new societal and technological developments, especially in dealing with controversial preferences and interests. The area of drug policy change presents an excellent example for discussing the problem and the process of coalition building for finding acceptable answers to new challenges. Modern sociological theory has developed concepts and tools for a description and analysis of such processes. Some concrete case studies from Swiss cities are available as a basis for advanced discussion of theoretical concepts. The observational description of the coalition building in the city of Zurich helps to illustrate the inherent elements, problems and outcomes; a more detailed process analysis focuses on the initial phases and further development of the various formal and informal coalitions, introducing the importance of shared objectives for action and the need for concerted activities. A clear policy concept and a consistent action plan were not available at first, but they proved to be an important step in the consolidation of what was a non-systematic beginning. What started at local level and led to a new national policy was not so much a continued clash between two ideologies - harm reduction versus strict prohibition -, but was the beginning of a new thinking about how the various policy elements could successfully work together in the pursuit of a shared concrete objective. These observations may be considered in further theory development and policy considerations.