Archive for November, 2009

Alternative Treatment for Alcohol Abuse; Marijuana (cannabis)

Posted By Dr. Sean Breen on November 21st, 2009

As medical director for Medical Cannabis of Southern California I often evaluate patients who want to stop drinking alcohol.   Alcoholism obviously destroys the life of the patient and the people they have relationships with.  I have had several patients who have been able to stop drinking and instead have substituted with cannabis.

Obviously, the BEST option for these patients would be to stop drinking altogether and not have to rely on any drug.  Many patients can successfully use 12 step programs and alcoholics anonymous to stop drinking.  But what about the patients who can’t?    In my professional opinion you have to then take a path of harm reduction and try to substitute alcohol with a less toxic and harmful substance that will work.   Many times I find that what the textbook says we should do as physicians and what is practical for patients doesn’t always match up.    Many times patients will say “when I come home from work I need to unwind, know I shouldn’t drink but need to just to relax.  If I could medicate with cannabis it would do the trick and keep me from drinking.”   Even though it is not ideal I think it is a viable approach to eliminating alcohol from their life.

Although I still believe that ultimately every alcoholic needs counseling and a definitive 12 step or like plan to completely heal themselves, they can medicate with cannabis and not continue to damage their bodies.   Cannabis has not been found to be toxic to any of the major organ systems if not smoked. It is a very good medication for anxiety, insomnia, pain and many other medical conditions.  You can not over dose on it and it is not physically addicting.   It has been used safely for over 4000 years and up until the 1940’s it was part of the US Pharmacopeia.

If you  would like more information to determine if cannabis can help you eliminate or control your alcohol consumption please feel free to make an appointment by calling 877-721-0047 or visit our website at www.mcsocal.com.


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Marijuana (Cannabis) and Polymyalgia Rheumatica

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

As medical director for Medical Cannabis of Southern California I often evaluate patients who complain of muscle and joint pain.   Two days ago I had a patient come into my office with the diagnosis of polymyalgia rheumatica who discovered that cannabis can help reduce muscle inflammation and pain.

Polymyalgia rheumatica (PMR) is a disease characterized by muscle and joint pain.   It is result of the bodies white blood cells attacking the joints and surrounding tissue and causing inflammation which leads to pain.  The pain mostly occurs in the shoulders and hips but can also affect the upper arms and thighs.   The onset of pain can occur suddenly or gradually and typically can wake patients up at night.  Commonly patients will wake up  in the morning with pain and stiffness in the joints.  The average age of onset is 70 but mostly occurs after the age of 50.   Women are two times more likely to suffer from this as men.

I recently evaluated a 56y/o man who complained of PMR and had difficulty sleeping at night because of the pain in his shoulders.  The Ibuprofen that his doctor prescribed was causing stomach ulcers and because of the increasing dose it started to affect his kidneys.   He had tried both Ambien and Lunestra for sleep but it made him “feel like a zombie” in the morning and it was affecting his work.  He was feeling hopeless and could not think about having to suffer like this for the rest of his life.

A week prior to coming to see me he was over a friends house who had used cannabis for arthritis. He worked up the courage to try and vaporized two doses that evening.   What he told me was that “it was a miracle drug”.   HE SLEPT GREAT AND WOKE UP FEELING REFRESHED AND HAD A 75% REDUCTION IN HIS NORMAL PAIN!!!

The reason why this worked so well for him is that the medically active ingredients in cannabis (cannabinoids) have both analgesic (pain relieving) and anti-inflammatory properties.  There are over 60 cannabinoids in the plant and together the produce a physiologic change which leads to a reduction in patients symptoms.   Secondly, because cannabinoids bind to areas in the brain it is a great medication for sleep.  Patients wake up feeling refreshed.

If you suffer from Polymyalgia Rheumatica and would like more information about cannabis please visit my website at www.MCSoCal.com or call 877-721-0047 and make an appointment to come into my Irvine or Long Beach office.

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Alternative Treatment for Vertigo; Marijuana (Cannabis)

Posted By admin on November 12th, 2009

As medical director for Medical Cannabis of Southern California I often evaluate patients who complain of vertigo to see if cannabis can help with their symptoms and improve the overall quality of their life.

Vertigo is the sensation of spinning or swaying while the body is actually stationary.  In most cases it is a symptom as a result of a primary disease process.  Most of the time it is caused by malfunctions in the inner ear or vestibular system.   Common causes are infections, Migraine headaches, Meniere’s disease labyrinthitis, benign positional vertigo and a host of other disease processes. On a physiological level there are multiple neurotransmitters (chemical messengers) which play a role in vertigo.    The dizziness can lead to nausea and vomiting which is very debilitating.

Yesterday I evaluated a 49 year old male who has been experiencing chronic intermittent vertigo for the past three years.   He suffered from regular nausea and vomiting.   It affected his appetite and he had been losing weight as a result of poor nutrition.  The battery of tests that his doctor ordered failed to identify the exact cause.   The treatment plan had been to try traditional medications.   He had been given anti-histamines, SSRI’s like fluoxetine (prozac), gabapentin (Neurontin) and valium. None of these had given him any relief and he suffered from many side effects as a result.

One month prior to my evaluation he had been given cannabis by a family friend in the midst of one of his attacks where he was severely nauseous.   To his amazement it almost completely eliminated his nausea and he regained his appetite.  As a result he worked up the courage to come to my office to see if he qualified under California’s proposition 215 which gives patients the right to cultivate, possess and transport cannabis in california.

Upon evaluation I determined that the benefits of trying cannabis far outweigh the risks.   He left yesterday with a recommendation and went to purchase medicine within 5 minutes of leaving my office.  I was very encouraged by his feedback and look forward to following up with him in a few months.

If you would like more information about cannabis to see if it can improve the quality of your life please visit our website at www.MCSoCal.com or call our professional staff at 877-721-0047.    Dr Sean Breen has two offices located in Orange County and Long Beach and see patients daily.

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How do I tell me Doctor I use marijuana (cannabis) for my condition?

Posted By Dr. Sean Breen on November 7th, 2009

As medical director for Medical Cannabis of Southern California I often discuss with patients how they should share the information about their cannabis use with their doctor.  Many patients are apprehensive about it in fear that their primary care physician or specialist will not want to continue taking care of them.   “My doctor is very conservative and would never approve of this” they say.   Or “my doctor also takes care of my whole family and I don’t want it getting back to them.”

First, your physician is bound by patient privacy laws called HIPAA.   He is not allowed to share any of your information with anyone, even if it is your spouse or parent.  If he does it is a felony punishable by sever fines, prison and loss of medical license.

Second, although you doctor may be conservative, it is important he has a complete picture about your health and withholding any information is only hurting you the patient.    It is not your doctors job to judge you.   He is simply there to give you the best medical advice possible based on your situation.   He should weigh the benefits and risks of each treatment option and present you with a plan of action.   You ultimately decide what you want to do but mostly trust he is providing you the correct treatment approach.

However, in life, it matters how you say things.  For example,  ”Honey, you look horrible in that dress. Can you put the other one on I like” vs “Honey, I love how you look in that other dress. Can you wear that one tonight.” Everything is sales unfortunately and this is no different. If when speaking with your doctor you say “I’ve been smoking pot (smoking weed/getting high/smoking joints/using dope etc) to help me sleep.”  you will come across as a “stoner” and he will most likely not want to engage in a discussion about your cannabis use.   However if you say to him “Dr. Greenthumb,  I have been having so much trouble sleeping for the past year and none of the sleeping aids we have tired have been successful.   The ambien (trazodone/valium) we tried makes me too groggy and I have not been able to function the next day.  What I have found to really help is that I have been medicating with cannabis 20 minutes before going to bed.   I get a great nights sleep and wake up feeling rested.”

If you use the second approach you will come across like a patient and he much more likely to entertain a discussion.   He still may not approve of it but it will certainly keep the lines of communication open.  The key to this is to say “medicate with cannabis” and to also tell him why the other medications are not improving the quality of your life.

Thats the cannabis tip of the day!

Dr. Breen

Posted in Medical Ethics
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Finding the right medical marijuana (cannabis) dispensary/collective

Posted By admin on November 7th, 2009

As medical director for Medical Cannabis of Southern California I am often asked by patients how to find the best collective to purchase their medicine.

It’s a great question because you must be very careful when choosing to work with any specific collective to purchase your medicine.   Most of them are not operating according to state law.  They simply set up shop and hope to make as much money as possible before they get shut down or caught.   They do not have the proper corporate structure, legal documents, sales licenses and accounting practices.  I can not stress the next statement enough.

YOU DO NOT WANT TO EVER PURCHASE MEDICINE FROM DISPENSARIES NOT IN COMPLIANCE WITH STATE LAW!


The question becomes how do you find a collective that can provide you with the best quality medicine and is in full compliance with State law.  They are out there but unfortunately are in the minority.   Here are some things that they MUST do if they are in compliance with State law.  If you go into one and they do not follow the following procedures simply leave and look for another one.

1. They must have articles and by-laws available for you to read and offer you the opportunity to do so.  If they don’t then they are not complying with state law.

2. They must have you sign an executing agreement.

3. They must have you sign a release to verify with your doctor that you are a patient.

4. You must sign any documentation regarding the rules of the collective.

5. They should have you sign a release of liability.

6. They must verify your recommendation with your doctor and ask to see your ID. The legitimate ones have access to the internet to do so.  If they don’t simply do not use them as they most likely have not followed proper procedures.

7.They should be professional, the location should be safe and they should be VERY knowledgeable about the types of medicine.  They should sit down and spend time with each of you and answer all of your questions.

If they follow these procedures then chances are that the have had proper legal counsel and operating per California law.

Lastly, the quality of the medicine should be excellent.  Many places offer 30 varieties but 28 of them are not effective.   The best dispensaries only need four quality strains.  1 Indica, 1 Sativa, 1 Hybrid-indica, 1 Hybrid-Sativa

A note regarding edibles (brownies/cookies/lollipops/honey/teas etc):

Unless you plan on making your own edibles for ingestion I DO NOT recommend that you purchase edibles from dispensaries.   The reason is that there is NO quality control.  When tested they have found to contain Salmonella, E-Coli, Aspergillus (fungus) and FECAL MATERIAL. The “cooks” are not being monitored by the department of health.   Many times edibles sit without being properly refrigerated.  I have seen edibles that are covered with mold. Lastly they vary in quality and it is very difficult to predict to strength until it is too late.


For more information on determining whether cannabis is an appropriate medication for your condition please visit our website at www.MCSoCal.com and pre-qualify for free online.

Posted in medical Marijuana Law
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What exactly is the medical cannabis (marijuana) card?

Posted By Dr. Sean Breen on November 4th, 2009

As medical director for Medical Cannabis of Southern California I am often asked to explain what the medical marijuana “card” is.  There is a lot of misinformation concerning patients rights under Proposition 215 and what doctors can actually recommend cannabis to patients.

Proposition 215

What Proposition 215 basically said, without boring you to death with minutia,  is that patients who may benefit from the use of cannabis can cultivate, possess and transport cannabis in the state of California as long as a doctor feels that they can benefit from its medicinal effects and gives them a written recommendation.   ANY doctor, MD or DO, can recommend cannabis to a  patient. You MUST have completed medical school to recommend cannabis.   There is no special licensing or additional training that doctors go through to become “cannabis experts.”  However because cannabis is a schedule 1 drug per federal law, it is obviously not taught or mentioned in medical school.  Therefore, most doctors do not understand its pharmacology or effects on the body and do not feel comfortable recommending it to patients.   In most cases they are worried about liability for doing so.   In my case I decided to read everything I possibly could about cannabis and cannabinoids.  I simply immersed myself in the books and more importantly the culture.  I spoke with hundreds of patients about their conditions and how cannabis has affected their lives until I felt comfortable writing recommendations for patients to consume cannabis as a medication.

What is the Marijuana Card?

Now back to my original question.  What is the card?  When California passed Prop 215 they tried to implement a state ID card system to identify patients who doctors recommended cannabis for.  Patients would bring their doctors recommendation to the county office and they would register and pay the fee.  The county then issued them a “card” similar to a drivers license that said they were a legal cannabis patient.  The point was to protect them from law enforcement and prosecution.  The problem was that the program was voluntary and cost patients on average $150.00 annually.   And because most patients did not want to register ANYWHERE, let alone with the state of California, 90% of patients did not voluntarily get the state card.  However, patients still needed access to medicine.   So what developed was a system where some patients had the state card and the rest just used the written recommendation that their doctor issued them to get medicine from the local collective/dispensary.

As a result of this double jointed/parallel system for identifying medical cannabis patients, what some clinics started doing is issuing their own “card” to identify their patients.  The only problem is that these “cards” that doctors are handing out to their patients provide ZERO benefit or protection under the law.  They are simply a marketing ploy to make patients think they are protected by their “special” card.  They provided their patients NO additional benefit over the written recommendation.

Current Medical Marijuana Card System

So what is the system look like as I type this?  Every patient now has to present their WRITTEN RECOMMENDATION when obtaining medicine or interacting with law enforcement.  The “card” in and by itself is useless.  99% of the collectives/dispensaries require patients bring in an original written recommendation from their doctor.   However the “card” is commonly marketed by doctors because that is what the majority of the public thinks they need.  It is however completely false.   In fact the card provides a false sense of security because these clinics tell patients to just keep the card in their wallets and present it to law enforcement.

In conclusion, their remains in place an ID card system started by the state of California.  The ID Cards that doctors offices provide are worthless.  The WRITTEN RECOMMENDATION is the gold standard for patients when using cannabis for medicinal purposes. ANY physician can legally recommend cannabis for their patients.

If you would like more information on whether or not you could benefit from using cannabis please feel free to schedule an appointment to be evaluated in one of my three southern California clinics.  Call 877-721-0047 or visit www.mcsocal.com and pre-qualify for FREE online.

Posted in medical Marijuana Law
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Alternative Treatment for Restless Legs Syndrome; Cannabis (Marijuana)

Posted By Dr. Sean Breen on November 4th, 2009

As medical director for Medical Cannabis of Southern California I have the opportunity to evaluate patients who present with the diagnosis of Restless Legs Syndrome.  Most of these patients come to me after having an incredible experience with cannabis to treat their symptoms.  The following is an actual patient I had in my office yesterday.

Brian P is a 65 y/o man who came into my office with his wife of 35 years.  He is suffering from advanced Parkinson’s disease and was unable to speak and had the typical shuffling gait.  His wife informed me that he suffers terribly from restless legs syndrome.  His symptoms are typical; an strong urge to move his legs when lying down to go to bed that has prevented him from getting a solid nights sleep in many months.  The insomnia is starting to take a toll on his health as he has a difficult time functioning throughout the day without a good nights sleep.  His wife explained that they have tried everything that modern medicine has to offer; He has been on high dose Motrin, Hydrocodone (Vicodin), Neurontin, Requip; has avoided any caffeine and alcohol, started walking more during the day, used heat and massage and “nothing has helped my husband.”

What brought them to my office was a result of a chance encounter with a friend of theirs who also suffered from restless legs.   He happened to treat his symptoms with cannabis (marijuana).  He told my patient that 30 minutes prior to going to bed he simply vaporized a pure cannabis indica strain.  The overall relaxation that cannabis provided in addition to the muscle relaxation had allowed him to sleep through the night.   My patient was encouraged and tried the same regimen that night and “it changed my husbands life.”  He finally fell asleep without difficulty and woke up feeling rested.    Since that time he has used cannabis when he has access to it but came in to see me so that he can get a medical cannabis recommendation and have safe access to medicine daily.   I am very hopeful that Brian’s symptoms will be reduced greatly and he can sleep well!

This story is not atypical in my practice.  Cannabis works very well for symptoms of restless legs because it causes a relaxation of the muscles and in addition affects the dopaminergic system in the brain just like many medications for restless legs.  The great thing about cannabis is that it has very few side effects, especially if not smoked.  It is not toxic to Brians major organs and he has ZERO chance of overdose.  Compared to opiate narcotics (like hydrocodone) cannabis is much safer and more effective.  I challenge any pain management doctor to put his arsenal of medications up against cannabis and see whose patients get a better result.

If you would like more information about medical cannabis and whether or not you can benefit please feel free to contact my clinic by calling 877-721-0047.   Our clinics are located in Irvine and Long Beach california.  www.mcsocal.com

Dr Sean Breen is committed to helping patients improve the quality of their lives by discussing the benefits and recommending the use of cannabis.  He can be reached by emailing drbreen@me.com

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