April

One thing that endears me to the BCMJ is the editor’s page. DRR writes thoughtful, often funny comments about the world around us. His December 2018 editorial, “Sleep, when it no longer comes naturally,” [BCMJ 2018;60:478] was a bit of a departure from his usually joyful character, and reading it filled me with concern and empathy for him. It revealed his struggle with anticipatory anxiety insomnia, wondering each night if sleep is going to come to him.

Chronic musculoskeletal pain is common in our society. One in five people suffer with chronic pain in Canada. We need alternatives to pharmacologic interventions that are cost effective, safe, and available to most patients. Ideally, these alternatives would be covered by MSP. Most importantly, alternative treatments could decrease our reliance on opiates.

I thank Dr Mitchell for his opinion and for standing behind the quote, “There are biochemically distinct strains of cannabis, but the sativa/indica distinction as commonly applied in the lay literature is total nonsense and an exercise in futility.”[1]

In effect, Dr Mitchell is saying “strain does not matter.” I can’t say Dr Mitchell is wrong, but it does not align with the data we collected.

This article [BCMJ 2019;61:14-19] would be the first in the literature to establish different clinical effects from C. sativa and C. indica strains. While Dr Ocana insists that clinical research supports separating these strains because of their different effects (stimulating vs sedating), the reference he provided does not support this or even use these differing strain names.