Posts Tagged ‘cannabis indica’

Long Term Affects of Medical Marijuana on the Brain and Cognitive Function; A discussion

Posted By Dr. Sean Breen on July 29th, 2010

As medical director for Medical Cannabis of Southern California I evaluate patients daily for the use of medical marijuana.   Often patients ask me if cannabis (marijuana) has any long term adverse effects on the body.  It is a great question and one that can not be answered with 100% confidence until more research and studies are completed.   Cannabis research has been limited because of the federal governments currently classification system which states that cannabis is a schedule 1 drug (no medicinal value).  It is difficult to get any funding to study this incredible plant.

Before I discuss what is currently known about marijuana’s affects on the central nervous system short and long term I want to stress that you always have to weigh the benefits and risks of any medication that you take.  And in the case of marijuana you have to consider what medications you WOULD BE TAKING instead of using cannabis and the risks that they pose as well.   Most of the time cannabis is much safer and effective.

Most people have heard someone say at one time or another “that guy is burnt!”… meaning their brain is pretty much fried and they are not solving any calculus equations anytime soon.   The question becomes: does long term use of cannabis adversely affect the brain.   Short term, while acutely medicated, it is pretty clear that cannabis has an affect on short term memory, attention, coordination, balance, reflexes and hinders higher executive functioning (learning and problem solving).   It is for this reason that patients must be very responsible when medicated.   Researches believe that most of these symptoms are a result of THC (tetrahydrocannabinol) which is that main psychoactive ingredient in the plant.   There are over 60 other cannabinoids that we know of in the plant which also exert their effects on the body. An example is cannabinol which is believed to have anti-inflammatory and analgesic properties without the psychoactive affects that THC has.   This is significant as we move forward with therapeutic applications of the plant.

In the long term the research is less clear.   There have been studies that have shown that long term (chronic  daily) heavy users do exhibit some impairment in higher cognitive function (executive functions such as learning and problem solving) but it is difficult to distinguish from the loss of cognitive functioning that occurs naturally with aging.   There have been studies that demonstrated that chronic cannabis users also have a higher incidence of psychiatric comorbidity like anxiety, depression and irritability.    Certainly I have discussed cannabis use with patients who have been medicating for 30 years or more and they do say that if they don’t have access to cannabis they experience increased irritability, mood swings, insomnia and at times depression.   These are considered moderate withdrawal symptoms that some patients can experience.  It is for this reason that we suggest patients take “drug holidays” every few months for about 1-2 weeks to give their bodies a break and chance to “reset” their natural endogenous cannabinoid system.

One of the other questions is if regular heavy use of cannabis affects an individuals drive or motivation.  People describe users having “amotivation syndrome.”   They question whether cannabis affects their ability to reach goals etc.     My personally feeling is that in recreational users this can be the case.    However using cannabis as a medication is completely different.  Patients typically use less psychoactive strains of cannabis and are using much smaller doses.   Most patients just want relief of their symptoms and nothing more.   In these situations I have not found cannabis to affect a patients ability to work or reach goals.   Most get more sleep, are less stressed and have less pain which allows them to be more productive.

Overall I would say that cannabis in therapeutic doses for medicinal purposes poses very few adverse affects to overall patient functioning.  The major organ systems are not affected and the the acute psychiatric affects of the medication are limited.   Long term, patients do much better because 1) they are not dependent on other medications and 2) their day to day quality of life is improved.  I clearly think that the benefits most patients receive outweigh the risks of using cannabis long term.

If you have questions or comments feel free to contact me at any time or come in for an appointment. 877-721-0047 or www.mcsocal.com

We have two full time offices in Irvine and Long Beach California.

Be blessed,

Dr. Breen

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How does medical marijuana (cannabis) reduce pain?

Posted By Dr. Sean Breen on July 6th, 2010

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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Behcet Syndrome, Arthritis and Medical Marijuana (Cannabis); An Alternative Treatment

Posted By Dr. Sean Breen on June 15th, 2010

I recently evaluated a 54 year old women for medical marijuana (cannabis) who suffered from Behcets Syndrome. Specifically she complained of painful arthritis in her knees and ankles.  She had been taking prednisone and NSAID’s for many years and wanted to try an alternative more natural treatment.   Her rheumatologist recommended she try cannabis for her persistent joint pain.

Behcet’s syndrome is very rare in the United States.  It mostly affects men and women who live in the middle east and asia.  It is a disease that causes inflammation of the blood vessels.   It is characterized by painful ulcers in the oral mucosa (mouth, gums and tongue) and genital region.   They look like your typical “canker sore”.  Patients also can suffer from visual changes as a result of inflammation of the blood vessels in the eye.   Two thirds of patients suffer from arthritis in the knees and ankles (most commonly).  Less commonly patients can have lesions in the brain that affect patients balance and coordination.  Also some patients can form clots in their veins.

The reason why patients with Behcet’s syndrome can experience relief using cannabis is because the plant has over 60 cannabinoids which influence the immune cells and reduce inflammation.   It also binds to the nerves directly and reduces the amount of pain that patients experience.

My patient reported using cannabis on 3 occasions in the past month and on each occasion experienced a significant reduction in the pain in her knees.   Even though she felt “anxious” about coming in to see me she could not deny the benefits she experienced.  After speaking with her and going over both the risks and benefits of using cannabis she felt relieved that she will finally get regular relief.  I expect that she will do very well and cannabis will become a routine part of her treatment plan.

If you suffer from Behcet’s Syndrome or pain for any reason and would like a professional medical evaluation to see if cannabis can improve the quality of your life simply make an appointment to come in.  My staff will be able to answer many of your questions and schedule an appointment.  877-721-0047

Be blessed,

Dr. Sean Breen

Medical Cannabis of Southern California is the most respected clinic for providing patients with medical marijuana recommendations.  Our offices are located in Irvine and Long Beach California.

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NSAIDS (motrin, voltaren) increase risk of heart attack and stroke study finds; Medical Marijuana as an alternative

Posted By Dr. Sean Breen on June 15th, 2010

An important study just came out in the periodical “Circulation: Cardiovascular Quality and Outcomes” which demonstrated an increased risk of fatal and non-fatal heart attack and stroke for healthy patients who routinely use NSAIDS (non-steroidal anti-inflammatory drugs) such as motrin, ibuprofen, diclofenac, voltaren, celebrex, naprosyn, aleve etc. to treat pain.  This is a very important study and you those patients who routinely pop motrins or take dicofenac to treat pain need to read.    Marijuana has for many years been found to have potent anti-inflammatory effects without any of the increased risks associated with commonly prescribed NSAID’s.

The study examined the risk of heart attack and stroke in over 1 million patients who averaged 39 years of age and had no significant health problems (high blood pressure, heart disease, diabetes etc) over an 8 year period.    They found that patients who regularly used NSAID’s to treat chronic pain were 29% more likely to have a heart attack or stroke.   This is significant because how many people do you know (you included) head to the local CVS and pick up a bunch of Motrin for that chronic pain or ache without considering the side effects??  They estimate that 20% of the population has been PRESCRIBED (not including those who get it over the counter) NSAIDS at one time or another for pain.

We are beginning to understand in medicine that many treatments that we used to believe were safe are actually significantly dangerous to patients (for example hormone replacement therapy in post-menopausal women).   NSAIDS can cause significant gastro-intestinal bleeding and now we find out increase the risk of heart attack and stroke significantly.

One thing the study did find is that if you really need to use an NSAID for pain the safest one in the study was Naprosyn, commonly known as Aleve.

You may not know that there are over 60 cannabinoids in the cannabis (marijuana) plant that exert their effects on the body.  Many of them specifically decrease the inflammatory response and thus reduce pain.   Cannabis has very few unwanted side effects.  You can not overdose from it!   It does not effect your kidneys or liver.  It is not addictive.  It does not cause ulcers or bleeding.  It is one of natures best remedies for pain and inflammation.

I can not tell you how many older patients I see everyday that want to stop taking their “pain pills” for chronic pain.   The stories I hear about how cannabis has improved the quality of their life are truly remarkable.  They love being able to vaporize it as opposed to having to smoke it.

I HIGHLY recommend that if you are suffering from chronic pain (for any reason) that you come into my office and we can discuss the benefits and risks of using marijuana to treat your symptoms.   Simply call 877-721-0047 or pre-qualify for free online and one of my staff will contact you shortly.

Dr. Breen, Medical Director, Medical Cannabis of Southern California


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Veterans and Medical Marijuana; A Special need

Posted By Dr. Sean Breen on June 1st, 2010

As medical director of Medical Cannabis of Southern California I often meet patients who are combat veterans and are in need of help.   One of the blessings in my life was the opportunity to serve along side the Marines of 1st Battalion 4th Marines in Iraq from January-September 2003. I witnessed combat from the front lines and experienced the buffet of emotions that our troops go through on a daily basis.   Now that I am honorably discharged I can openly discuss the benefits of using cannabis to take care of:

1. The anxiety they experience.

2. The anger they may feel at times.

3. The depression, isolation and loneliness they feel.

4. The chronic pain that they are suffering from.

It is quite an honor and a privilege to be able to sit down with them and TRULY understand what they are going though.   Most of them need ongoing therapy which hopefully they get through the VA.  However instead of having to take oxycontin for pain, xanax for anxiety, ambien for insomnia and lexepro for depression they can simply try medicating with cannabis to regulate all of these symptoms.   I have had great success with many veterans over the past two years and really enjoy working with them.  They truly are the few and the proud.   They simply need help.

If you are a veteran and would like to discuss the benefits and risks of using cannabis for medicinal purposes feel free to make an appointment.  call 877-721-0047 or send me an email and I will answer your questions.

Semper fi,

Dr. Breen

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Alternative Treatment to Soma (carisoprodol), Marijuana; Marijuana Evaluations in Orange County and Long Beach

Posted By Dr. Sean Breen on May 29th, 2010

As medical director of Medical Cannabis of Southern California I often evaluate patients who are taking Soma (carisoprodol) for muscle spasms.   Typically they are frustrated because it not only is ineffective (for many patients) but they worry about being addicted and being on it for prolonged periods of time.   Cannabis is a great alternative to Soma for patients who have muscle spasms.

Soma is a medication that works as a muscle relaxant by depressing the central nervous system which in turn relaxes the muscle tone in the body.   The exact mechanism of action is unknown.   The problem with this medication is that it should only be used for 2-3 WEEKS at a time because it has a high addiction potential and patients also develop tolerance to it.    It can also cause significant drowsiness which makes it difficult for patients to complete meaningful tasks.

For patients who suffer from chronic pain taking Soma regularly is not (or should not) be an option.   I have had many cases where patients can get a much better response from using cannabis in small doses without the worry of addiction or unwanted side effects.   Cannabis also helps them sleep better which greatly improves the quality of their life.

The research is pretty clear that cannabis reduces muscle spasms from all disease processes.   Everything from Multiple Sclerosis to acute muscle strains can be treated with cannabis.  It works by binding to receptors on the nerves that control the individual muscles and provide an overall relaxation.   It has NO potential for addiction and is extremely safe.  It is not toxic to any of the major organ systems and can be inhaled smoke free using a vaporizer.  Its effects will last 3-6 hours depending on your metabolism.

If you live by one of my two offices (Irvine and Long Beach) and would like to see if you qualify for a medical marijuana card feel free to contact our office at 877-721-0047 or visit us online at www.mcsocal.com and pre-qualify for free.

Have a great day.  Feel better.

Dr. Breen

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Xanax vs Marijuana (cannabis) for Anxiety: Medical Marijuana Orange County and Long Beach

Posted By Dr. Sean Breen on May 29th, 2010

As medical director for medical cannabis of southern california I provide medical marijuana recommendations for patients throughout Orange County and Long Beach.  One of the most common complaints that I here from patients is that they are tired of taking Xanax to treat their anxiety because of all the side effects and want a safer more natural alternative.   Marijuana has been shown to have incredible anxiolytic properties and has limited unwanted side effects.

Xanax is a drug that is most commonly used to treat anxiety and panic disorder.  It falls into a class of drugs called benzodiazepines.   It works by binding to areas in the brain that regulate a compound called GABA.  GABA has an inhibitory affect on the brain, meaning it slows everything down.

Unfortunately benzodiazepines have a plethora of side effects.   The first is that patients build up a tolerance and dependance which means they require more and more to get the same effect over time.   Xanax can become highly addicting and patients can experience withdrawals when they try to stop.  On top of having to worry about becoming addicted to xanax patients most commonly experience the following:   DROWSINESS, LIGHTHEADEDNESS, DEPRESSION, HEADACHE, CONSTIPATION, DRY MOUTH, CONFUSION, NAUSEA AND VOMITING, AMNESIA

MORE SERIOUSLY PATIENTS CAN HAVE: INCREASED HEART RATE, SEIZURES, BREATHING DIFFICULTIES

Most commonly patients tell me they walk around feeling like a “zombie” and they “can not function on it.”

Cannabis has been shown to have incredible anxiolytic properties.   It is NOT addicting, you can not overdose and it has very few unwanted side effects.  It can be used daily in small doses with better results than xanax.  Patients report using it prior to bed time and they say it not only helps them sleep but regulates their mood for 24-48 hours following.

If you would like more information on how cannabis can treat your anxiety I would be happy to discuss the benefits of using cannabis with you.  Give our Irvine or Long Beach office a call at 877-721-0047

www.mcsocal.com provides medical marijuana recommendations to patients who qualify under California Proposition 215.

Dr. Sean Breen

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“You’re my last hope”: Marijuana and Peripheral Neuropathy

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

Today in my Irvine office I had the honor of taking care of Kathryn R.  She is an amazing 83 year old women who developed peripheral neuropathy (pain originating from damage to the nerves themselves) from taking a drug called amiodarone to treat her atrial fibrillation.   When I introduced myself to her she said “you are my last hope.”

Kathryn suffers from so much pain that she described wanting to give up on her life.  Her husband died 4 years ago and I could sense she was at the end of her rope.   Although I felt an intense sadness I was encouraged because she had never before tried cannabis and I am so optimistic for her.   She is so tired of taking “pain pills” (opiates) that not only don’t work but constipate and nauseate her.

The majority of the clinical research that has taken place with cannabis has been studying peripheral neuropathy and neuropathic pain.   Cannabis has shown to reduce pain in small doses.   On top of the analgesic effects Kathryn also complained of a lack of appetite and difficulty sleeping.    She also suffered from nausea from the laundry list of medications she is taking.

Cannabis is extremely successful in helping elderly patients get sleep.  It allows them in most cases to sleep throughout the night and they do not wake up feeling groggy.

The biggest risk for patients like Kathryn are injuries sustained from falling.  Cannabis can effect a patients balance and coordination and extra pre-cautions have to be taken in elderly patients.  She gets around with a walker at home and does not have to use stairs which is a bonus.

By the time Kathryn left my office I could sense her attitude had changed as the thought of getting a goods night rest after eating a nice big dinner started to sink in.   She came in with her daughter who was also very encouraged.

Kathryn- I think you will do great.  You will be in my prayers.  Hang in there and hopefully cannabis will help you find a renewed hope in life.

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Alternative treatment for Irritable Bowel Syndrome (IBS): Marijuana (Cannabis)

Posted By Dr. Sean Breen on May 11th, 2010

This morning in my Irvine CA office I had my annual follow up with a 22 year old female who came in last year as a result of severe Irritable Bowel Syndrome or commonly known as IBS.  Her symptoms were severe nausea, lack of appetite and intermittent diarrhea.  She explained that for past year her symptoms have improved tremendously.    She has been medicating with a sativa strain twice per day and very rarely has nausea.  Her appetite is greatly improved and she very rarely has any diarrhea.

Because of the improvement in her symptoms she has been able to stay in school and is working towards a business degree.   She reports that her overall quality of life is “100%” better.

It are patient stories like this that give us cannabis physicians the satisfaction of doing what we do.   Here was a young women who was suffering greatly just a year ago and within months is back on track to living a productive life with only mild symptoms of IBS.

If you would like more information on whether or not cannabis can help control your IBS please feel free to pre-qualify online or give my staff a call at 877-721-0047.  Have a great day.

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Dilantin (Phenytoin), Seizures and Marijuana (Cannabis): An alternative treatment

Posted By Dr. Sean Breen on April 29th, 2010

I recently evaluated a 52 year old male patient who suffered from Nocturnal Seizures and had been started on Dilantin (Phenytoin).  He said that although the medication was working to reduce the amount of seizures he suffered from severe fatigue and “zero appetite”. He was coming for a recommendation to use medical cannabis as he has been using it with “amazing results” and wanted to “be legal”.

Dilantin is a medication used in patients that suffer from seizures.   Unfortunately it has many debilitating side effects and its blood levels have to be monitored.  This patient was suffering from severe fatigue and no appetite.  He stated that he used a sativa strain of cannabis which increase his energy levels during the day an also gave him a healthy appetite.  Without it he would suffer to the point of not wanting to take his medication.  Unfortunately the consequences of having seizures would be disastrous.   So cannabis was a perfect fit in his situation.    Cannabis has also shown to have anti-seizure properties which is an added bonus.

Other common side effects of taking dilantin are abdominal pain, constipation, dizziness, drowsiness, nausea, vomiting, unsteady gated, abnormal involuntary movements and overgrowth of the gums which requires good dental hygiene.

If you take dilantin and would like to see if cannabis is right to help you deal with it’s side effects I would be happy to go over your medical history and see if it’s a good option.

As medical director for Medical Cannabis of Southern California I currently see patients full time in my Orange County and Long Beach offices.  To make an appointment feel free to give my staff a call at 877-721-0047.

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