Medical marijuana patients show up on timel A friendly reminder

Posted By admin on July 16th, 2010
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To all my amazing patients:  this is just a friendly reminder that if you are not going to be able to make your appointment to PLEASE PICK UP THE PHONE AND LET US KNOW.  We understand that things come up and your schedule changes but by letting us know  aren’t going to make it we can book another patient for your time slot. It really helps our office and staff to get that call!

Thank you in advance.  We work extremely hard on making sure you are seen at your scheduled time.   Unlike other clinics we DO NOT accept walk ins. You will not have to sit and wait for 15 people to see the doctor before you.   We value your time very much and run a very unique and professional clinic.

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Tags: Dr Sean Breen, medical cannabis of southern california, Medical Marijuana, medical marijuana evaluations, medical Marijuana Law

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Stay Healthy with Crossfit; Medical Marijuana

Posted By Dr. Sean Breen on July 17th, 2010
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The formula for a healthier body is not magical.  Stay fit (maintain a normal body mass index and weight) and eat healthy foods.    Burn more calories than you take in.   There have been thousands of books and diet plans to get in shape.   If you are looking for a magic pill forget it.  THE BEST FITNESS PROGRAM TO STAY IN SHAPE IS CROSSFIT

Most people have never heard of Crossfit but it is starting to gain some serious momentum.   Crossfit is a strength and conditioning program that will challenge an olympic athlete.   I have been going to a local crossfit gym for the past 6 months and have seen incredible gains in strength and endurance.

What is it?   Simply, each day www.crossfit.com post a workout of the day (WOD) and every member goes through that exact workout.   You can not imagine how amzzing these workouts are.   UFC/MMA fighters come into these gyms and get gassed.

I recommend this to all patients who are struggling to regain their health and/or are frustrated with their current fitness program.  The variety of these workouts is staggering.

To find a crossfit gym by you visit www.crossfit.com and click on “affiliates”   My wife and I go to www.crossfit714.com in Orange.  The owners/trainers are amazing and will help people of all fitness levels make incredible gains.

ONLY IF I HAD THIS IN COLLEGE WHEN I WAS PLAYING BASEBALL!

3-2-1…  Be blessed,

Dr. Breen

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Tags: Crossfit, crossfit714, www.crossfit.com, www.crossfit714.com

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Polymyalgia Rheumatica and Medical Marijuana; Alternative Treatment

Posted By Dr. Sean Breen on July 21st, 2010
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Today in my Irvine office I took care of a 71 year old man who suffers from Polymyalgia Rheumatica (PMR) and wanted to see if medical marijuana could reduce his symptoms and decrease the amount of prednisone that he is taking.   Specifically, PMR is characterized by pain in the muscles of the neck, shoulders, lower back and hips/pelvis.   It’s key pathology is inflammation which in turn leads to pain.   The reason why medical marijuana works so well is because the cannabinoids(medically active ingredients in the marijuana plant) have both anti-inflammatory and analgesic (pain reduction) properties.

PMR typically affects patients older than 50.  It is very common that patients also have giant-cell arteritis (temporal arteritis) which is inflammation of the medium and larger arteries.   Commonly patients have headache, jaw claudication (pain) and sometimes visual changes.   The reason for these is that the artery most commonly affected runs across the temple’s bilaterally (temporal artery).

PMR is difficult to treat.  Typically patients get placed on a course of prednisone which is a big gun drug to reduce inflammation in the body.    PMR symptoms will usually improve dramatically when given prednisone.   The duration of initial treatment can be weeks to months.   50% of the patients will have flare-ups when the prednisone is tapered.

The problem with prednisone is that is has A LOT of side effects. Weight gain, psychosis and mood swings, fluid retention, increased appetite,  swelling, easy bruising, headache, insomnia and muscle weakness (there are many more but these are the most common).  My patient was having a lot of edema (swelling) and his mood swings were unbearable (according to his wife)   He had been using medical grade marijuana for the past two weeks and has had good results.    His pain has been reduced dramatically and he is sleeping much longer and throughout the night…. something he hadn’t done in “years”.

The goal for a patient like this is to help him wean off the prednisone, pain killers and sleeping pills and substitute with cannabis.  Certainly it is a very obtainable goal.

If you suffer from arthritis or muscle pain and/or have been diagnosed with Polymyalgia Rheumatica and would like to see if medical marijuana could potentially help you feel free to contact us by calling 877-721-0047 or through our website at www.mcsocal.com

Be blessed,

Dr. Breen

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Tags: back pain, Dr Sean Breen, giant cell arteritis, headaches, hip pain, hyperglycemia, increased appetite, jaw caludication, leukocytosis, mood swings, neck pain, optic neuritis, PMR, polymyalgia rheumatica, prednisone, shoulder pain, temporal arteritis, vasculitis, visual changes, weight gain, www.mcsocal.com

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How to Defend a Medical Marijuana Patient Arrested for Growing Marijuana

Posted By Dr. Sean Breen on July 23rd, 2010
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Today I had to appear in court for a patient of mine who was arrested in San Diego for intent to sell marijuana.  He and another patient set up a grow on their property with 180 plants.   They were both legal patients.  Today was a preliminary hearing in front of a judge to determine if their was probable cause that a crime was committed to proceed to trial.   The burden of proof for the prosecution is very minimal.

My role was to testify on behalf of my patient that he was in fact a legal patient, had the right to grow marijuana for consumption and was growing a reasonable amount of medicine.   After stating my credentials my patients attorney attempted to ask me: “In your opinion, what is a reasonable amount for a patient to possess for personal consumption?”

Here was the problem: Prior to asking me that question the district attorney who was prosecuting the case on behalf of the people asked me the following questions: My answers are in bold.

1. Did you receive any specific medical training to prescribe or recommend cannabis? No there is no specific training that physicians are required to go through to be able to recommend cannabis.  Any doctor can recommend marijuana to a patient.

2. Have you taken any additional CME (continuing medical education) courses which makes you an expert in marijuana?  No I have not.  (i actually forgot that i did in fact once take an online CME course about the affects of cannabis on the body)

3. Are there any studies that you know of that specifically recommends how much medicine a patient should use? There are plenty of studies to include ones conducted at the UCSD Medical Cannabis Research Center which describe patients benefiting from the use of cannabis but I can not recall without having them in front of me whether or not specific amounts of cannabis were recommended.    (It is not legal for a doctor to tell a patient how much marijuana to use… per my patients attorney)

4. Do you personally have any experience using marijuana for medicinal purposes? No I do not.

5. Do you tell patients how much marijuana to consume? No as a doctor I tell my patients that can use whatever amount of marijuana that is required to relieve their symptoms. Some patients require more or less than others.

So the problem became when my patients attorney asked me “What I thought would be a reasonable amount for a patient to posses?”  The D.A. quickly argued “Objection, No foundation.”  Meaning I can’t really cant answer the question because it would just be an opinion not based on any expertise or clinical studies or personal use.  He argues I have no personal experience and that  there are no studies that I was aware of saying patients need “X” amount of marijuana to treat chronic pain.  The judge agreed and did not allow my patients attorney to ask me the question.

I personally am not aware if there are any studies that discuss using a set amount of marijuana for any particular illness.  As physicians we really can not discuss a recommended dose because there is no guidance from the medical community.

The truth is there is not any recommended dosing schedule for marijuana.  What I would have answered is that marijuana is unique in that patients can not go the the local drug store and pick up their medicine.   Medicine in dispensaries is often expensive and for many patients the best course of action is to grow as much medicine as possible so they can be assured that they have enough medicine to treat their symptoms.   With many dispensaries being closed it would behoove a patient to have enough marijuana on hand so that they did not have to rely on getting it from an outside source.   This patient would have had enough medicine to last a few years and could have saved a lot of money by not having to go through a collective.

The defense brought in an expert to testify that having 180 plants for two people is reasonable given the yield for new growers (which these patients were).  They could anticipate losing about half their plants because of their inexperience and if they made edibles they could certainly use the rest for personal consumption…. especially if you take into account that there is no real time limit to use all of it.  They could have harvested once and had medicine for 1-3 years.

Here  was another MAJOR PROBLEM for the defense. One of the patients, after the police read them their miranda rights, answered a bunch of questions at the time their residence was raided.   One of which was “what are you intending to do with all of these plants?” To which she allegedly replied “We are going to use some for personal use and also SELL some to our collective.”   She should NEVER have said anything… because she made that one comment made it hard to argue that it was all for personal consumption…. which they very well could have.  The moral of that story is TO NEVER SAY ANYTHING EVER TO LAW ENFORCEMENT UNTIL YOU SPEAK WITH AN ATTORNEY! YOU HAVE THE RIGHT TO REMAIN SILENT.

I do not know what the outcome of this preliminary hearing was as I left after my testimony.   But this issue that came up during my testimony is most likely a hurdle that many attorneys are going to have to jump over if they are trying to defend a specific number of plants that a patient was growing.   Given that the State supreme court ruled that it is unconstitutional for the court to tell a patient what is reasonable… situations like this are doing to be more common moving forward.    If Prop 19 passes it will only make things MORE CONFUSING!

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Tags: Medical Marijuana, proposition 19, Proposition 215, san diego county medical marijuana, Senate Bill 420

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Medical Marijuana (Cannabis) and Inflammatory Bowel Disease, Crohns Disease, Ulcerative Colitis; An Alternative Treatment

Posted By Dr. Sean Breen on June 23rd, 2010
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Today in Irvine I took care of 2 patients who were suffering from  Crohn’s Disease and Ulcerative Colitis that were using medical marijuana to help control their symptoms.    Primarily they stated the cannabis reduces abdominal cramping, decreases diarrhea and decreased the amount of “flare ups” that they had in the past 12 months.

Many patients are unaware that cannabinoids (the medically active ingredients in the plant)  have anti-inflammatory properties in addition to having analgesic properties.  At it’s roots Inflammatory Bowel Disease is caused by inflammation in the walls of the large and small intestines.   Essentially immune cells congregate and cause inflammation which leads to its symptoms of cramping, diarrhea, nausea, anorexia etc.

Typically patients are treated medically with drugs that block the inflammatory response.   Mesalamine, corticosteroids and immune modulators all essentially do the same thing which is reduce inflammation.  However many of these medications have unwanted side effects and patients need “something else” to help them.

IBD effects a very high percentage of the population. It can be extremely debilitating and often times leads to early death.   Many patients have to have portions of their intestines removed because the inflammation is so severe.

I have found in my practice that patients who supplement with cannabis have better control of their symptoms.  They require less corticosteroids (like prednisone), have less hospitalizations, trips to their doctor and have a healthier appetite.     Once patients get used to vaporizing the cannabis they realize that they can incorporate it into their treatment regimen with ease.

If you or someone you know is suffering from IBD, Crohns or Ulcerative Colitis and would like more information to see if cannabis can improve the quality of your life feel free to give us a call at 877-721-0047 . You can also pre-qualify for free by visiting our website at www.mcsocal.com

Be blessed,

Dr. Breen

Thank you for helping us spread the word with Social Media

Tags: corticosteroids, crohn's disease, IBD, immune modulators, inflammatory bowel disease, marijuana clinic, medical marijuana card, mesalimine, ulcerative colitis

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Going to Pot: The Science Behind Marijuana; Fox News; Dr. Mark Siegel

Posted By Dr. Sean Breen on June 24th, 2010
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I just read this article at Fox New’s website (see link) discussing the dangers of using medical cannabis. Please read it. http://liveshots.blogs.foxnews.com/2010/06/22/going-to-pot-the-science-behind-marijuana/#

In this article Dr. Mark Siegel, a practicing internist in New York’s NYU Medical Center, is quoted as saying “The idea that it(cannabis) needs to be commonly used, there’s no medical indication for that whatsoever. Not only that, it has a risk for lung cancer associated with it, a risk of psychiatric problems, anxiety, depression, dissociation and suicide.”

I WISH FOX NEWS WOULD HAVE ME ON TO DEBATE HIM ON THIS ONE!

For one you can’t make a blanket statement about any medication.  You have to look at it in the context of the individual patient.   For example, it ABSOLUTELY is indicated for daily use in many patients.   Patients who live in chronic pain whose only other option are Fentanyl patches or Morphine/Ocycontin are the perfect example.  How about patients who can not get sleep or wake up throughout the night and can’t tolerate Xanax, Trazadone, and Ambien.  Is cannabis not a safer option for them?

Cannabis causes lung cancer?   I agree that if you smoke it you are increasing your risk for malignancy.  Cannabis smoke contains carcinogens.   But here’s a question for you Dr. Siegel:  Are you aware that most patients in California use a vaporizer and expose themselves to NO SMOKE or CARCINOGENS.    You DO NOT have to smoke cannabis in order to use it.  So I suggest you read up a little bit more before you make a blanket statement about whether or not cannabis is indicated for every day use under ANY circumstance.

Cannabis leads to an increased risk of suicide?  There is NO LEGITIMATE DATA about the increase in suicide rates and cannabis.   HOWEVER I can show you numerous studies and PATIENTS that HAVE COMMITTED SUICIDE as a result of being placed on SSRI’s (Zoloft, Paxil, Prozac) for depression.    Why then, if a patient tells you that “Cannabis really improves my mood, reduces my anxiety and helps me function” would you not consider them using it as an alternative.

In an ideal world patients do not take any medications and are completely healthy.  But the reality is that modern medicine in many instances does more harm to a patient than it does good.    Patients regularly become opiate dependent, commit suicide because of an SSRI, develop perforated ulcers because of chronic use of NSAID’s (motrin, alleve), die of heart attacks because of medications like Vioxx and Celebrex etc.  The list GOES ON AND ON.

FOR MANY OF THESE PATIENTS CANNABIS IS AN EXCELLENT ALTERNATIVE.

OK. WHAT SAY YOU???

Respectfully,

Dr. Breen

Thank you for helping us spread the word with Social Media

Tags: Dr Sean Breen, Dr. Mark Siegel, fox news, Medical Marijuana, medical marijuana evaluations, Proposition 215, Senate Bill 420, www.foxnews.com, www.mcsocal.com

Similar Posts ShareDigg Stumble it! Reddit Trust Pharmaceutical Companies? Read on. Keeping the integrity of Proposition 215 intact: Right? Medical Marijuana: The trojan horse? Posted in Medical Ethics, Uncategorized, medical Marijuana Law Comments 22 Responses to “”Stephen W says:July 5, 2010 at 12:22 am

Wow! Dr. Breen, you seem like a very passionate supporter of medical cannabis. I hated taking Paxil, it just made me feel weird! I almost felt better with my high anxiety. How can I make an appointment with your office to obtain a medical cannabis prescription? I haven’t taken Paxil since my Dr closed his practice almost 4 years ago. I live in Los Angeles. Thanks for your blogs.

admin says:July 5, 2010 at 5:24 am

Stephen- I here from patients every day that do great with cannabis. I was cautiously optimistic when I got started but the stories from my patients energize and invigorate me. Simply give my staff a call at 877-721-0047 and they will schedule for you to come in. I look forward to taking care of you! Dr. Breen

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How does medical marijuana (cannabis) reduce pain?

Posted By Dr. Sean Breen on July 6th, 2010
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As medical director for Medical Cannabis of Southern California (MCSoCal) I regularly evaluate patients with chronic pain for a medical marijuana recommendation. (approximately 65% of the patients I see are for pain)  The question that many patients ask is: How does marijuana reduce pain? Although cannabinoids (medically active ingredients in marijuana) effects on pain have been studied there is a lot of research left to do.   My goal of this post is to break down “barney-style” how cannabis reduces pain.  I am not going to bore you with the specific scientific details as you will most likely fall asleep like I often do reading typical double-blind placebo studies!

OK here it is.  The brain is considered our central nervous system.  The spinal cord and the nerves that exit the spinal cord that project to all of the organs, muscles, vessels and skin are considered the peripheral nervous system (there is also an autonomic nervous system but ignore that for now)   Think of nerves like the electrical wiring that runs throughout the house.   To keep this simple let’s take the bones and tissues of the knees (a common complaint I see is arthritis of the knee)  If you have pain in the knee it is because the nerves (wires) that originate at the knee are in a very excited state.  They get activated and send the signal through the nerve (headed to the brain ultimately) which makes it first connection in the spinal cord.

Once at the spinal cord that nerve typically connects and communicates (via neurotransmitters… chemicals that allow one nerve to communicate with another) with a new nerve in the spinal cord which runs all the way up the spinal cord and terminates in the brain.

Once in the brain that signal is processed and it sends it back down a new set of nerves (originating in the brain) which run back down through the spinal cord.   So thus far we have knee—–>Spinal Cord—–>Brain—–>Back down spinal Cord—–> lastly a nerve leaves the spinal cord and ends back at the knee where ultimately the patient feels pain.

They way marijuana works (that we know of thus far) is that it specifically binds to a receptor on the nerves themselves and blocks or slows down the transmission of pain up and down the spinal cord to the brain. The electrical wiring (nervous system) in our body has what we call receptors on it along the way (Think of receptors as door locks).   Each of these locks has a specific key that opens it and causes it to have a specific function.   When you inhale cannabis you inhale specific “keys” that go and search out these specific locks on the nerves.   When they find them they bind to them and cause the nerve to be less excitable which ultimately slows the transmission of pain throughout the nervous system.

Now, in my effort to keep things simple and stupid I know that there are scientists out there who will read this and say… “yeah but thats not exactly how it works.”  However, in a more general sense this is how marijuana reduces pain in the body.

If you are a person that wants to get into the nitty-gritty science behind this you can read plenty of studies which discuss the physiology of CB1 and CB2 receptors.   The CMCR at UCSD has published a study on cannabinoid analgesia and it is accessible online.

If you suffer from pain and would like to discuss using cannabis to improve the quality of your life please feel free to make and appointment to come in and see me at my Irvine or Long Beach CA office.   Simply call 877-721-0047 or pre-qualify for FREE at www.mcsocal.com

Be blessed,

Dr. Breen

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Tags: acute pain, anandamide, cannabis, cannabis indica, CB1 receptor, CB2 receptor, central nervous system, Chronic Pain, D. Sean Breen, endogenous cannabinoids, marijuana, Medical Marijuana, opiate analgesia, peripheral nervous system, spinothalamic tract

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