Archive for March, 2010

Marijuana (Cannabis) and PTSD (post traumatic stress disorder)

Posted By Dr. Sean Breen on March 31st, 2010

Today in my Irvine clinic I had two patients who were suffering from Post Traumatic Stress Disorder (PTSD).  One was unfortunately physically and verbally abused by her boss and the second was involved in a very traumatic car accident where he lost one of his best friends.   Both of these patients experienced a combination of difficulty sleeping, recurring nightmares, avoidance and depression.

The first step in their recovery process involved psychotherapy which both were receiving.  One of them had started group therapy as well.   These two treatment modalities are pretty standard for patients who suffer from PTSD.

At this point many of you reading this may be wondering why and how they ended up in my office?  The reason is because each was started on 4 medications and for one a 5th was added.   One stated that they “felt like a zombie” and the others emotions “were completely dulled”.   Here is the list of medications that they brought in.

1) Trazodone: is an anti-depressant which affects the serotonin levels in your brain: in these cases it was being used to assist with insomnia.

2) Ambien: is a drug used to induce sleep as well.  It works similar to benzodiazepines in that it binds to the GABA receptors in the brain.  Patients often are worried about the addiction potential and complain of feeling very groggy upon awakening with daytime drowsiness that can affect work performance.

3) Lorazepam (Ativan): is a drug used to treat acute anxiety and insomnia.  Is a benzodiazepine and affects the GABA receptors in the brain.  Patients often worry about its addiction potential and increasing tolerance and dependence.

4) Prozac (Fluoxetine): is a drug most commonly used to treat depression.  It affects the serotonin receptors in the brain.   Many patients complain about it’s side effects.  Specifically, it can affect a patients sex drive and sexual performance.

5) Seroquel (quetiapine): is a drug often used to treat schizophrenia and bipolar disorder.  Often I have seen patients prescribed this to assist with insomnia as well.

The problem that these patients had with their psychiatrists treatment plan is the  amount of medications that they were taking throughout the day.  They literally felt like walking zombies; out of touch with their personal relationships.  They also experience unwanted side effects.  This is a very common theme that I hear from patients.

So where does cannabis come into play?  For one I think the goal is to get these patients off there medications used to treat the anxiety and insomnia.  For these patients the goal was to eliminate the need for the Ambien, Ativan and Trazodone IMMEDIATELY.

I encourage them to continue the prozac if it is helping with their mood.  As long as the side effects are not too bad I think this is a reasonable medication for them to stay on until the therapy allows them to cope without any medications.

Many times the goal for my patients is to substitute cannabis for one or more of the medications that they currently take.  Cannabis, if used appropriately, can replace many varieties of medication.  It can assist with falling asleep, decreasing anxiety, improving mood, stimulating appetite  and also decreasing patients use of other drugs such as alcohol.

I will follow up with them in a few weeks and blog about how they are doing. Stay tuned!

If you would like more information on seeing if cannabis can improve the quality of your life please feel free to call my staff and schedule an appointment to come in.  I would be happy to take care of you.

Visit us at www.mcsocal.com or call 877-721-0047

Posted in Uncategorized, disease treatment
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From 18 oxycontin per day to 2 in 2 weeks!!

Posted By Dr. Sean Breen on March 30th, 2010

A week ago I blogged about a women by them name of Sam who had been taking 12 Norco and 6 Oxycontin daily for the past 5 years.   I was elated when after ONE WEEK she had decreased her opiate use to 4 Norco and 4 Oxycontin.

TWO WEEK UPDATE: Sam is down to ONLY 2 PILLS A DAY!!!! She takes one oxycontin in the morning and a norco in the afternoon.  I sat down with her and this is what she said.

“CANNABIS HAS SAVED MY LIFE!”  WOW!  LAST MONTH HER PCP WROTE HER A PRESCRIPTION FOR 600 OXYCONTIN!!!! INSANITY.

I realize that running this practice is NOT going to be a glaring star on my resume.  In fact many of my colleagues will shun me for being a part of this industry and this medicine.

BUT IT IS THE SAM’S OF THE WORLD THAT KEEP ME MOTIVATED AND REMIND ME THAT I AM DOING THE RIGHT THING!  WHAT A SUCCESS STORY.

I AM GOING TO TRY TO GET HER TO DO A VIDEO TESTIMONIAL FOR THE WEBSITE.  SHE IS SUCH AN INSPIRATION TO ME AND WILL BRING HOPE TO ALL THOE PATIENTS WHO HATE THEIR PAIN PILLS!

Posted in disease treatment
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Keeping the integrity of Proposition 215 intact: Right?

Posted By Dr. Sean Breen on March 30th, 2010

Proposition 215 allowed medical doctors to recommend the use of cannabis to their patients to relieve their symptoms.  14 years later this poor proposition has been raped and beaten worse then Hedda Nussbaum (see wikipedia for you non New Yorkers).  It’s integrity has been stripped to its core.  Greed and crime has taken over.  It has been so abused by the professionals who intended to use it in their scope of practice that it has almost become a joke in California.

Think about the actions of physicians: falsifying medical records, selling patient lists to dispensaries (HIPAA violation) and outright not following the standard of care when prescribing a medication.  How about opening a medical clinic where a Physician assistant (who is not allowed to recommend cannabis) stamps a doctors signature who HAS NEVER MET THE PATIENT. How about patients showing up to a cannabis clinic without EVER being evaluated by a doctor and receiving a recommendation for a phantom diagnosis.   The california medical board clearly states that patients must have been evaluated  for their condition by their primary care doctor or specialist prior to receiving a recommendation.

How about the actions of dispensaries: Selling 4 ounces per week to the same patient knowing that THERE IS NO WAY  they are using that all for themselves and are most likely selling it illegally.  Not paying their sales taxes to the state.  Not documenting their revenue.  Laundering money!

All of these examples are MAKING IT VERY DIFFICULT FOR LEGITIMATE BUSINESS OWNERS (BOTH DOCTORS AND COLLECTIVE OWNERS) to stay in business.

If you have any doubt to whether or not these things are taking place… contact the State of California medical board and ask for the public records of the investigation into Dr. Alfonso Jiminez.  I contacted them.  I read the entire investigation and findings.  I was utterly disgusted.   Dr. Jiminez’s medical license was revoked at the conclusion of that investigation.   You can read them and draw your own conclusions.

How about the dispensary owner caught with $140,000 in cash in his car that was NEVER going to be declared to the state of california.   REVENUE + MONEY LAUNDERING makes it difficult for a legit collective to stay competitive with pricing.

I THINK ITS TIME THAT THE MEDICAL CANNABIS COMMUNITY HAS A GUT CHECK.  IT’S  TIME WE LOOK OURSELVES IN THE MIRROR AND ASK:

“AM I DOING THE RIGHT THING?”

TO PATIENTS:  I ASK THAT YOU ONLY SUPPORT CLINICS AND COLLECTIVES THAT ARE OPERATING LEGALLY.  RECOMMENDATIONS FOR $45 FROM PHYSICIAN ASSISTANTS ARE DESTROYING THE MEDICAL INDUSTRY.  STOP BUYING FROM COLLECTIVES NOT PAYING THEIR STATE SALES TAX.

Posted in Medical Ethics
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Medical Marijuana: The trojan horse?

Posted By Dr. Sean Breen on March 30th, 2010

As medical director for medical cannabis of southern california I am well aware that many recreational users are taking advantage of Proposition 215 to use and cultivate.   Unfortunately, recreational uses can walk into a physicians office and show them evidence that they once fractured their ankle or once spoke to their doctor about indigestion  and walked out with a prescription for prilosec.   They then produce this medical documentation to receive a recommendation to use cannabis for medicinal purposes.

It is difficult for me to look at every patient that walks into my office and try to figure out who is using it for their medical complaint…. and who has a legitimate medical complaint but is using cannabis recreationally.    Both patients will leave with a recommendation as per California Law they qualify.  But in reality only one patient is being truthful.

Malingering is something that doctors deal with in their practices, but in the cannabis industry it is very common.

Unfortunately, many cannabis medical clinics COULD CARE LESS if their patients are legitimate!  How do I know this??  Pretty simple. I can not tell you how many patients I see that have received previous recommendations that have NEVER ONCE been evaluated for their complaints.  They simply walked into the doctors office and said “my back hurts” and paid the fee and walked out with a recommendation.

Today was classic in my Long Beach office.  A patient by the name of Shaun walks in to renew a recommendation that he received from Medicann a year ago.  Shaun goes on to tell my office manager that he has to appear in court tomorrow because he was arrested for growing over 20 plants in his house for the purpose of distribution to a list of his “friends.”   I went on to ask him what the name of his collective was and he responded “oh Im not a collective.”  To which I responded “then why are you cultivating and selling cannabis to a group of people  illegally.”  It was a rhetorical question obviously.

He then went on to ask me to write a letter for the court that he needed to grow 20+ plants because he makes edibles.  Basically he asked me to lie on his behalf so he could look better in court tomorrow.  EVEN AFTER HE TOLD ME GROWS TO DISTRIBUTE!!!  WHAT A MORON!

The bottom line is that I told him I was not willing to be his doctor because he is breaking the law and growing illegally.   He was PISSED because he had brought his medical records for his psoriasis and intended on leaving with at least a recommendation.

As a business owner the easy thing to do would have been to take his $100 and give him a recommendation….since he had a legitimate medical complaint and his medical records with him.   In reality he was full of shit and using Prop 215 as a trojan horse for his illegal grow operation.

As this industry begins to spiral out of control… it is up to us to POLICE OURSELVES to protect the integrity of Prop 215 and SB 420.

Posted in Medical Ethics
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Tired of Side Effects of Prednisone? Try Cannabis

Posted By Dr. Sean Breen on March 27th, 2010

As medical director for medical cannabis of southern california I often evaluate patients who take regular high doses of prednisone.  Prednisone is the atomic bomb for inflammatory conditions such as crohns, ulcerative colitis, sever asthma and many other medical conditions.   Unfortunately it’s effects do not come without significant side effects.  Many patients can get relief of these side effects by using cannabis.

Typically patients who have to take prednisone experience sleeping irregularities, abdominal pain and bloating, appetite issues, nervousness and restlessness.  Many times it can cause an acute and temporary psychosis.   Prolonged use can cause weight gain, headaches, muscle pain and severe restlessness.

Unfortunately many patients who take prednisone have few other options.

ENTER CANNABIS.

Patients who use cannabis to combat some the more common side effects of prednisone typically respond and do much better.  In addition, because cannabinoids have anti-inflammatory properties it can relieve the inflammation and decrease the amount of prednisone that patients have to use.

I recently followed up with a 42 women with severe colitis (inflammation of the digestive tract) who within 6 months was able to stop her use of prednisone completely!  She is sleeping better, has an increased appetite (she was losing weight secondary to not eating…not good) and has less abdominal pain and indigestion.

This is common with many patients that I evaluate.  If you or someone you know is taking prednisone regularly and would like an evaluation to see if cannabis can help please feel free to contact my office at 877-721-0047 and schedule an appointment.

Be blessed and have a great day!

Dr. Breen, Medical Director www.MCSoCal.com

Posted in disease treatment
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Can’t sleep? Economy, Family, Health

Posted By Dr. Sean Breen on March 25th, 2010

As medical director for medical cannabis of southern california I am amazed at the amount of patients who have difficulty falling asleep or wake up throughout the night.   One of my 10 commandments when it comes to perfect health is “Thou shall get sleep.  As your sleep goes so does your health.” You can eat perfectly and exercise all day but if you are getting adequate rest you will be prone to illness mostly secondary to a compromised immune system.

On a very basic level all of cells require glucose (nutrition) oxygen and a method of removing waste (lymphatic system).   Our body rests, cleanses and rejuvinates when we get sound sleep.

I won’t go into detail of the various stages of sleep and the brain waves that we can measure.  But what I will do is make it very simple and break this down BARNEY STYLE.

CANNABIS HELPS YOU FALL ASLEEP, STAY ASLEEP AND WAKE UP FEELING RESTED.

Unlike many sleeping aids such as Ambien (which is similar to a benzodiazepene ie. valium) which makes patients feel extremely groggy and tired the next morning, cannabis generally has little to no associated morning grogginess.

I can not tell you how many patients are using cannabis to treat acute and chronic insomnia!  I am glad that I can help improve the quality of their lives!

If you would like to find out if cannabis can improve the quality of your life please feel free to call my staff at 877-721-0047 and schedule an appointment to come to my Irvine or Long Beach office.

Respectfully,

Dr. Sean Breen

mcsocal@me.com

Posted in disease treatment
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Tax and Regulate 2010: Medical Marijuana

Posted By Dr. Sean Breen on March 25th, 2010

Tax and Regulate 2010 is a initiative being placed on the November ballot which would essentially legalize cannabis up to 1 ounce for personal use (RECREATIONAL AND MEDICINAL) for 21 years old and over. From what I understand, cities will still be able to determine whether or not it is legal in their particular city.  There are restrictions about not using it in public or in the presence of a minor (<21y/o).

I guess my question is how do you think this will effect current medical cannabis laws?   Personally I think very few patients would go and take the time and spend the money to see a physician when they can legally get up to an ounce from any dispensary in the area.   I often use the argument that it would be foolish to offer recommendations for patients to go and purchase a 6 pack of beer.

Would dispensaries be able to sell cannabis to anyone 21 and over who walked off the street?  Would places like liquor stores and 7-11’s offer cannabis as well?

I think that total legalization will set back the medical community because of the backlash against cannabis as a whole.   I also think that the physicians, me included, who have dedicated their time to working with patients will not have any incentive to continue in this pursuit.   Certainly we must make a living as well.

WHAT ARE YOUR THOUGHTS?

Posted in medical Marijuana Law
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Cannabis and Autism: Patient Study

Posted By Dr. Sean Breen on March 24th, 2010

This morning a mother by the name of Anne brought her 21 year old autistic son to my Irvine office to be evaluated for treatment with cannabis.   He suffers from sever autism; very agitated, violent, and is unable to speak at all.  He requires 24/7 supervised care which his parents assume.   Anne described never having any total relief from the stress of taking care of him.

Anne told me she had tried everything to limit her son’s agitation.   She routinely has to give him ativan (benzodiazepine) and he takes risperidone daily which is an anti-psychotic.

In my office he was extremely agitated, was continuously banging the desk, jumping up and down and a few times even tried to hit his mother.  I could see the desperation on her face as she said “we have tried everything and need your help.”

I went on to explain that although the lack of clinical trials with cannabis and autism that many parents have successfully used it to help their children.   Personally I think the benefits clearly outweigh the risks in treating his sever agitation.   Cannabis is an excellent sedative and tends to even out patients moods.  It seems to modify the extreme highs and lows of both depression and anxiety.

Our goal is for the patient to start with some tinctures or edibles as he is not able to vaporize.   If we can get him sleeping and calm throughout the day not only will be able to function better but Anne and her husband can get some rest and relief.  We often forget about the toll that autism can take on parents and siblings.

I am confident that this is the right direction for Anne and her son.

Stay tuned for updates on patient K and her mother Anne.

If you would like more information about cannabis and autism please feel free to contact my office at 877-721-0047 or visit my website at www.mcsocal.com

I look forward to speaking with you.

respectfully,

Dr. Sean Breen

Medical Director, Medical Cannabis of Southern California

Posted in disease treatment
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Cannabis Success Story: Opiate Withdrawal

Posted By Dr. Sean Breen on March 24th, 2010

This morning I had the pleasure of taking care of a 24 year old male who has been sober from heroine use for two years.  He has managed to maintain sobriety using methadone and suboxone (Subutex).  Both of these medications are opiates as well and can be equally addictive. Today was his last day of using subutex and he plans on using cannabis to manage any withdrawal symptoms that he experiences after finally stopping all opiate medications!

Symptoms of opiate withdrawal are:

EARLY:  Agitation, Anxiety, Muscle Aches, Increased tearing, runny nose, insomnia, sweating

LATE: Abdominal cramping, diarrhea, nausea and vomiting.

Amazingly the effects of cannabinoids can reduce or eliminate the majority of symptoms of opiate withdrawal.     Cannabis can reduce anxiety and agitation, improve sleep and helps normalize the digestive tract.

Keep in mind that 9% of the population is at any given time abusing prescription drugs; the majority being opiate narcotics.

For this reason cannabis has become a major player in the harm reduction aspect of treating addictions.

If you or someone you know is suffering from opiate dependence (to include vicodin, percocet, oxycontin, morphine, heroin, soma, norco etc) and would like to be evaluated for cannabis treatment please feel free to contact my staff and make an appointment.  Our toll free number is 877-721-0047 or visit our website at www.mcsocal.com

Respectfully,

Dr. Sean Breen

Medical Director,

Posted in disease treatment
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Beware of fake medical offices offering cannabis cards

Posted By Dr. Sean Breen on March 23rd, 2010

A note to my patients and potential patients:   as with any industry there are always individuals who try to break the rules out of greed.

Recently there have been multiple medical clinics being investigated and shut down because the individuals that are providing recommendations are not medical doctors.   ONLY medical doctors can recommend the use of cannabis as a medicine.   Physician Assistants (PA’s) and Nurses CAN NOT recommend cannabis.    They will tell you that you receive a doctors recommendation but what they are doing is faxing it off for a doctors signature who is not even present.  8 physicians are currently being investigated by the State medical board for this unscrupulous behavior.

What has happened is that local dispensaries that are operating FOR PROFIT are setting up “doctors offices” at their dispensary location as a way to generate revenue for the dispensary.  Unfortunately patients are unknowingly receiving ILLEGAL and INVALID recommendations. They typically offer prices in the $45 range to get a large volume of people coming into their dispensary where they make all their money.

These clinics also DO NOT require you to have medical records nor do they ask typically.  THAT IS AGAINST THE LAW.  YOU ARE REQUIRED TO HAVE BEEN PREVIOUSLY DIAGNOSED FOR YOUR CONDITION PRIOR TO BEING EVALUATED.

Patients ultimately are getting screwed because they ultimately realize that their recommendations are invalid and they wasted their time and money as they now have to visit a true medical doctor.

If you are thinking about using cannabis as a medicine DO NOT get evaluated in clinics that have a direct affiliation with a dispensary.  It is an illegal operation.

We at Medical Cannabis of Southern California take this business very seriously and have a completely professional clinic.  Our recommendations are guaranteed for 12 months and Dr. Breen performs a complete history and physical.

Call us toll free at 877-721-0047  to see if cannabis is something that can help you with your illness.  Visit us online at www.mcsocal.com

Posted in disease treatment
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