Archive for September, 2009

Alternative Treatments for Neuropathic Pain; Cannabis (Marijuana)

Posted By Dr. Sean Breen on September 27th, 2009

As medical director for Medical Cannabis of Southern California I frequently evaluate patients with neuropathic pain.   Neuropathic pain results from damage to the actual nerves in the peripheral or central nervous system rather than stimulation of pain receptors.   Diagnosis is suggested by pain out of proportion to tissue injury, pain described as burning or tingling and nerve damage detected on neurological exam.  This type of pain can result from damage to any level of the nervous system.   Specific syndromes include post herpetic neuralgia, post-surgical pain (postthoracotomy syndrome, postmastectomy syndrome), phantom pain (pain experienced after amputation of a limb), diabetic neuropathy, HIV-associated sensory neuropathy and complex regional pain syndrome (reflex sympathetic dystrophy and causalgia).  Tumors and herniated vertebral disks can also compress the nerves and cause neuropathic pain.

Many treatment options for neuropathic pain range from medications to nerve blocks to TENS (transcutaneous electrical nerve stimulation).  Because patients with neuropathic pain typically do not respond well to opiates (Percocet, Vicodin, Hydrocodone) there are other classes of drugs that are typically used.   Anticonvulsants such a gabapentin (neurontin), anti-depressants such as amitriptyline and corticosteroids such as prednisone are just three of many different drugs that patients typically try.  Most patients experience limited relief with this approach.  It is extremely important that the psychological effects of chronic pain are also addressed.

Many patients are unaware of the clinical research supporting the use of cannabis (marijuana) to treat neuropathic pain.  The Center for Medicinal Cannabis Research at the UCSD has completed three clinical research studies demonstrating the efficacy of cannabis in treating neuropathic pain.  In the first study by Dr. Donald Abrams (Cannabis for treatment of HIV associated peripheral neuropathy) demonstrated that cannabis reduced daily pain by 34% vs 17% with placebo.  52% of patients using cannabis experienced a 30% reduction in pain compared to 24% in the placebo group.   For more clinical trials please visit the CMCR website at www.cmcr.ucsd.edu

In addition to cannabis’s analgesic (pain reduction) properties it also can improve patients mood from its euphoric properties.   This is an extremely important component in the overall care of pain patients.  Cannabis also has a safety profile which is unprecedented when compared to other treatment modalities.   It is a fact that there has never been one documented overdose from using cannabis.  In addition it does not cause a physical addiction like many other pharmaceuticals.  It will improve a patients appetite, assist with falling and staying asleep and eliminate the nausea often caused by opiate analgesics.   Once patients are educated on the safety and efficacy of marijuana (cannabis) they will be more likely to give it a try.  In the majority of cases the benefits of trying it clearly outweigh the risks.

Lastly, patients do not have to smoke to get the immediate benefits of cannabis.  Vaporization is way to inhale cannabis without producing any smoke.  It is essentially smoke free.

For more information on how to determine if you may benefit from the medicinal use of cannabis please visit our website at www.mcsocal.com and pre-qualify for free online.  To schedule an appointment to meet with Dr. Breen simply call 877-721-0047.  We have three convenient office locations in Southern California (Long Beach, Irvine and Encinitas)

Western medicine has found many challenges in treating this type of pain and often patients with neuropathic pain have given up on ever living a pain free life.   They typically have concominant depression as a result of the daily pain that they suffer from.

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Alternative Treatment for Anxiety; Cannabis (Marijuana)

Posted By Dr. Sean Breen on September 24th, 2009

As medical director for Medical Cannabis of Southern California I evaluate patients frequently who complain of chronic anxiety.    Their symptoms range from always anticipating disaster, often worrying excessively about money, health, family or work.  Many times the source of their anxiety is difficult to pinpoint.  There anxiety goes beyond the normal day to day concerns that most people experience.  People who suffer from anxiety just cant seem to shake their concerns even though they may understand that they are worrying beyond what the situations warrants.   It seems like lately more and more patients are unable to focus, maintain their relationships and get a good nights sleep because of real economic concerns that they may be going through.   This state is one that if not taken care of will burn out patients adrenal glands, suppress their immune systems and lead to collapse of their overall health.  Quite often I hear patients tell me “I am at the end of my rope and need help.”    Typically patients who present to their primary care physicians with these symptoms get quickly diagnosed with Generalized Anxiety Disorder and prescribed medications.  The most common medications that I see patients come in with are Valium or Xanax (which are a class of drugs called benzodiazepines)  These drugs interact with a compound in the brain called GABA and ultimately lead to relaxation.  The problem with these drugs are that not only is there a high incidence of dependence and tolerance but frequently lead to abuse.   Also patients will tell me that “they relax me but I am a complete zombie and can’t not live like that.”   Their emotions are completely blunted and there quality of life is not improved which is the goal of any treatment.  Secondly patients get placed on medications such as Lexapro which are used to treat both depression and anxiety.   Unfortunately, these medications produce many sexual side effects which reduces the overall quality of life of the patient.   For example I just had a 30 year old women who came in to my office because she had been on Lexapro for anxiety for the past 2 years.  Although she said her symptoms have improved she has not had sex with her husband for almost a year because of lack of sex drive.  This was in turn causing a strain on their relationship and worsening her symptoms.

Many patients do not realize that cannabis (marijuana) is an incredible anxiolytic (anti-anxiety medication).   I works by binding to receptors in our central nervous system (brain/spinal cord) and peripheral nervous system (nerves which leave the spinal cord and extend to the rest of the body)   Within 3 minutes of inhaling (vaporizing) patients will experience a generalized body relaxation.  Soon after patients can experience euphoria which is great for patients who also have depression.  This  state will usually persist for 3-6 hours depending on the dose.   If used prior to going to bed patients often get a restful nights sleep and wake up feeling refreshed.   The advantages of using cannabis is that it is not toxic to any of the major organ systems, has no potential for overdose and also does not produce a physical addiction.   Many patients are also unaware that there are different strains of cannabis which produce different results when used.   Indica Strains tend to be lower in THC (tetrahydrocannabinol) which is the main psychoactive cannabinoid.   Patients will typically describe the effect as a general body relaxation vs a head high.  This allows patients to medicate and still be able to carry out normal conversations with family, friends and co-workers.    Because most people’s experience with cannabis has been from marijuana obtained illegally from the street they tend to have used Sativa strains which are much higher in THC and have more of a mind-altering effect.    Regardless, because cannabis is so benign from a toxicity standpoint, it is definitely worth a try to see if you will benefit.  I always tell my patients that the great thing about cannabis is that if you try it and it doesn’t help, you simply stop using it and in the meantime have done no harm to your body.   However most of my patients experience great relief from their symptoms.

For more information about Dr. Sean Breen please visit his website at www.mcsocal.com  Medical Cannabis of Southern California has three offices in Long Beach, Irvine and Encinitas.   Patients can pre-qualify for free online from the privacy of their home.   If you would like to make an appointment to see if you can benefit from the medicinal use of cannabis give our office manager a call at 877-721-0047

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Alternative Treatment for Insomnia: Marijuana

Posted By Dr. Sean Breen on September 18th, 2009

As medical director for Medical Cannabis of Southern California I evaluate patients with difficulty sleeping all the time.   Their complaints many times have one of two characteristics; difficulty falling asleep or frequent awakenings without the ability to fall back asleep.   Typically they have been to their primary care physicians who prescribe drugs such as Ambien or Lunestra.   Other times if anxiety or stress is the cause for their insomnia they are given benzodiazepines such as Xanax or Valium to help them sleep.  Trazadone is another common medication prescribed for sleep.   The common theme that I hear regarding these medications is that, although they help patients fall and stay asleep, they feel completely groggy and tired the following day.  This then makes them less motivated and productive at work and also affects their relationships.  The other issue is the side effects of many of these drugs.  For example, benzodiazapenes can be highly addictive and often patients develop a tolerance and dependence.  I always discuss with patients that you have to weight the benefits and risks of any treatment a doctor recommends.

Cannabis (marijuana) is an extremely effective sleep aid.   It’s advantages is that patients will get a restful sleep and not wake up feeling groggy.   It is not toxic to any of the major organ systems and has very few side effects.   Patients can simply vaporize*** a small amount 10-30 minutes before lying down.   Usually within 10-15 minutes they will be enough sedation to fall asleep adequately.  As far as a particular strain, cannabis falls into two general categories, indicas and sativas.   Indica strains tend to be better for sleep because they have a lower concentration of THC (tetrahydrocannabinol) are more of a sedative.  They are not going to produce the intense head high that many sativa strains can cause.   Indicas tend to be more of a “body high”.   They are also great for chronic pain.  Many of our pain patients who can not fall asleep as a result of not being to get in a comfortable position do really well with indicas.

If you would like to be evaluated by a physician to see if you may benefit from using cannabis please feel free to visit our website at www.MCSoCal.com and pre-qualify for free.   Dr. Sean Breen is medical director for Medical Cannabis of Southern California and treats patients at his three offices in Long Beach, Irvine and Encinitas.

***Vaporizers allow patients to inhale the medication without having to smoke it.  It is the preferable way to medicate for ALL patients.  For more info visit www.MCSoCal.com

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Alternative Treatment for Migraine Headaches; Marijuana

Posted By Dr. Sean Breen on September 16th, 2009

As medical director for Medical Cannabis of Southern California I routinely evaluate patients who suffer from severe and debilitating migraine headaches.   Their complaints range from intractable pain to severe nausea and photophobia.   Many patients are unaware of the incredible anti-emetic (nausea) properties of cannabis.  Within minutes of inhaling cannabis, patients report an almost complete elimination of any nausea.  In addition because cannabinoids bind to receptors on nerve cells it also functions as an analgesic (pain relief).  Lastly, because cannabis can function as a sedative, most patients report being able to fall asleep without difficulty.   Because cannabis functions as an anti-emetic, analgesic and sedative it is an ideal treatment for migraine headaches.  Cannabis also has very few side effects.  It is not toxic to any of the major organ systems and is well tolerated by most patients.

Did you know that you can medicate with marijuana without smoking it?   Vaporizers were developed by patients who want the advantage of inhaling the medicine (immediate absorption and fast onset of action) without the risks of smoking.   Vaporizers work by heating the plant to temperatures below the point of combustion (approximately 360 degrees)  and evaporating the medically active ingredients off the surface of the leaf.   The plant matter itself is not burned and left intact while all the THC and other cannabinoids are inhaled.   Patients are left with a smoke free vapor to inhale directly into their lungs.   In my practice I recommend using the Easy Vape Digital Hands Free vaporizer.   It is cost effective and very simple to use.

Medical Cannabis of Southern California provides cannabis evaluations for patients in California who qualify under Proposition 215 to use medical marijuana.  With clinics located in Long Beach, Irvine and Encinitas we see patients across southern California.   Patients can pre-qualify for free from the comfort of their home by visiting our website at www.mcsocal.com  If you would like to make an appointment you can reach our director of clinics at 877-721-0047.

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Treating Chronic Pain with Marijuana

Posted By Dr. Sean Breen on September 15th, 2009

Chronic pain is one of the most common complaints that I recommend medical cannabis for in my practice.  As a patient, any time you make a decision to start or stop a medication you always have to wiegh the benefits vs the risks.  The problem that most patients experience is that traditional western medicine is unable to treat the cause of the underlying pain and instead focuses on treating the pain itself.  Pain medications are generally categorized into Non Steroidal Anti-Inflammatory medications (NSAIDS) such as common over the counter medications like ibuprofen (Motrin) and opiate narcotics such as vicodin, percocet, hydrocodone and morphine.    The problem with these medications are that they come with many severe and dangerous side effects.   NSAIDS can cause abdominal cramping and ulceration which can lead to life threatening bleeding.  Older patients that have have compromised kidney and liver function have to be especially careful when taking NSAIDS.  Opiates are extremely dangerous medications and in my professional opinion are a dead end for treatment of chronic pain.  They regularly cause nausea, lack of appetite and constipation.   They are also highly addictive and many patients who use them chronically suffer withdrawals when they try to discontinue their use.   Patients also must be aware that opiates can bind the respiratory center of the brain and stop a patients breathing if taken in excess. Opiate overdose is very common in ER’s across the country.   It is because of these side effects that most of my patients hate taking them.  The risks simply do not outweigh the benefits. The problem is that modern medicine has not come up with a better alternative.

Many patients are unaware that there is a safer and more effecting alternative to treat chronic pain.   Cannabis (marijuana)  contains medical compounds called cannabinoids.  Scientists have identified cannabis receptors in the human body that are located in the central nervous system (brain and spinal cord) and the peripheral nervous system as well (the nerves that innervate muscles and organs).   This means that when inhaled they bind to the nerves that regulate pain throughout the body and “block” or dampen the body’s response to pain.   The amazing thing about these cannabinoids are that they have a safety profile that is unprecedented in medicine.   There has never been a documented overdose from cannabis.   In addition the potential for addiction is very small.  Most patients who have trouble controlling their use have other drug addictions.    Cannabis almost immediately relieves pain and eliminates the nausea that most patients experience from taking opiates.  One of the other side effects is that cannabis will stimulate a patients appetite which in many circumstances is necessary.   Many elderly patients have a difficult time healing because they are not getting the necessary nutrition that they need.   What I have found is that when these elderly patients medicate with cannabis they regain their appetites which improves their daily quality of life.  They simply have more energy to do the things that make them happy.   Patients can medicate through out the day without the fear of overdose or unwanted side effects.

Let me share a few examples of patients that I have recently evaluated in my medical marijuana practice in southern California.

Lisa M is a 48 year old female who was diagnosed with fibromyalgia.  She was evaluated by her primary care physician and started on high dose Motrin for pain during the day and given a prescription for Ambien to help her sleep at night.   After 3 weeks she returned to her physician because the Motrin was not effective and the Ambien was making her feel like a “zombie” the entire next day.  It was affecting her performance at work and she was becoming very frustrated.   When offered a prescription for percocet for break though pain she refused because her brother had developed an opiate addiction after being in a motor vehicle accident 5 years ago.  When I evaluated her she had only tried cannabis in her 20’s on a few occasions.  She had a neighbor with chronic pain who medicated with cannabis and encouraged her to come in for an evaluation.   When she visited my office I discussed the benefits and risks of using cannabis and she agreed to try a pure indica strain which not only is great for pain but will also help her fall asleep because of its sedative properties.   Within 2 weeks whe had stopped taking both her motrin and ambien and was vaporizing an indica kush 30 minutes prior to going to bed.

Nick V is a 42 year old male who was involved in a motor vehicle accident where he was rear-ended on the I-5.  He suffered 3 fractured lumbar vertebra and had been in sever pain.  As part of his pain management he had been through physical therapy, chiropratic care and massage.  In addition he was given prescriptions for vicodin to take during the day.   He had tried cannabis a month prior to my visit after medicating with one of his friends who again suggested he try it.   Immediately he was able to stop the vicodin and used cannabis solely for his pain management.

Medical Cannabis of Southern California is commited to providing patients a professional, compassionate and private consultation to determine if cannabis is an appropriate medical treatment for your condition.  We have office locations in Long Beach, Irvine and Encinitas.  To see if you are eligible under California law (proposition 215) simply visit our website at www.mcsocal.com and pre-qualify for free.  You will receive a call from one of our office managers to answer your questions.

About the author: Dr. Sean Breen is a former navy physician who spent 5 years on active duty with the United States Marine Corps at Camp Pendleton CA.  He is a decorated combat veteran and served his country in Iraq from Jan-Sep 2003.  His sole focus in medicine is educating patients about the benefits of using medical marijuana.

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Medical Cannabis of Southern California is the #1 choice for Medical Marijuana Cards among Medical Marijuana Clinics in Orange County, Los Angeles and San Diego.

Posted By MCSOCAL-OC on September 4th, 2009

Medical Cannabis of Southern California is committed to providing medical marijuana patients a safe and professional medical evaluation as allowed by Proposition 215 and SB 420. Medicinal marijuana has proven to be a successful alternative health treatment for over 250 diseases. Medical Cannabis of Southern California is not only committed to providing medical marijuana recommendations but also medicinal marijuana information and news. Medical Cannabis of Southern California takes pride in saving the patient money as well. This is why our medical marijuana cards come with a low price guarantee. We believe that patients should not be overcharged for their cannabis cards and renewals. These are just a few reasons why Medical Cannabis of Southern California has become the leader in medical marijuana clinics. Our doctors and staff look forward to serving you.

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