Posts Tagged ‘Dr Sean Breen’

Risks of Using Medical Marijuana

Posted By Dr. Sean Breen on August 16th, 2010

As a physician who regularly discusses the use of marijuana for medicinal purposes with patients it is my job to make sure patients understand all of the risks of using this medication.   In this blog I want to talk about some of the most obvious risks.   First and foremost, because cannabis affects a patients mental status, specifically their judgement, coordination, balance, perception and fine motor skills they have to be in a safe environment when medicating.

Elderly patients have to specifically be careful about falls.  Every day elderly patients fall and break their hips.  This leads to significant morbidity and mortality.  Hospitalization, infection and other complications can throw an otherwise “healthy” patient into an absolutely tailspin.  Patients should be cautioned about going up and down flight of stairs.   Waking up at night to use the restroom can be challenging for elderly patients because their balance is off when medicated.    This not only applies to elderly but all patients.

Patients should not drive or operate heavy machinery period.  I can not tell you how many people I hear say that people drive better under the influence of marijuana.   I would disagree.  Cannabis clearly affects reaction times and depth perception.   These two factors alone make a driver under the influence more dangerous on the road.

Other safety issues become general sedation.   Certainly patients can fall asleep while cooking or start a fire when medicating (not unlike cigarette smokers)  Parents should take extra caution to make sure that if they are the sole parent that they do not medicate until there is another adult at home.   I have known in two cases where Child Protective Services (CPS) have removed children from environments where parents were medicating “putting their children in danger”.

Certainly patients should not engage in physical activity that requires balance and full concentration.   I have seen the outcome of people medicating prior to surfing… and it’s not good.

Although many of these things seem obvious and common sense bullet points… we all know that there is nothing common about common sense.  Most people use good judgement but there are enough people who show they have no capacity to use good judgement.

Posted in Risks of Cannabis
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Medical Marijuana Dispensaries Targets for Crime: What are cities afraid of?

Posted By Dr. Sean Breen on August 16th, 2010

I keep reading about how cities are opposed to medical marijuana dispensaries because of how much they attract crime.  Hold that thought.  Recently I visited my local Chase Bank and they were in the middle of renovating the entire bank… to include bullet proof glass, updated surveillance cameras and offices for the individual bankers.   I had a working relationship with the bank manager and asked her why they were adding all of the security features and her reply was “we have had five bank robberies in the last 12 months.”

Interestingly I live right down the street from this bank and not once heard anything about it being robbed.  It never hit the newspapers, TV or radio yet 5 times in the past year it was held up at gunpoint.    I left thinking to myself “banks really do attract crime”…. yet they are scattered everywhere in the city of Orange and all had the approval of the city to be there.   Why do cities allow them?   Obviously that’s a rhetorical question but my point is banks attract way more crime than any medical marijuana dispensary.   FBI statistics for the first 3 months of 2010 showed 1160 bank robberies resulting in 35 people taken hostage, 2 deaths and 18 injuries.

It is honestly inevitable that any business that has cash and something of value for sale that there will be crime at some point.   However a medical marijuana dispensary is no different than a bank,  jewelry  or convenience store when it comes to being a target for criminals.   Part of the problem is that local ordinances have forced dispensaries to set up in areas where there is more crime in general.

I can say that the majority of patients I see for medical marijuana recommendations are middle age, conservative and mostly outstanding citizens.   They are not using cannabis for recreational purposes and just want a safe and professional location to pick up their medicine and go home.   They are not looking to loiter, disturb the neighbors or bring “blight” to the neighborhood.  In fact many live in the same neighborhood that their dispensaries are located.  They actually appreciate them.

Here are some recommendations that I think would make sense for cities when considering how to regulate dispensaries.

1. Require dispensaries to have merchant accounts so that they do not have to handle cash.   Right now most of the national banks will not open accounts for dispensaries because marijuana is illegal federally.  However until dispensaries can run credit cards that go to a bank they are forced to handle and keep cash on site.

2. Require all dispensaries have video surveillance.

3. Make it illegal to have armed security at dispensaries.

4. Perform background checks on all dispensary owners and their employees and not allow any person involved to have any criminal history.

5. Allow them to operate in medical facilities just like pharmacies do.  Do not restrict them to industrial areas way off the beaten path.   Patients should not be forced to drive to locations where it is obvious why they are there.   They become targets for criminals.   Treat dispensaries like any other business and allow them to operate where any other legal business can operate.  I believe that these people should be treated like patients.  It is intimidating enough for them to do to a dispensary… let alone force them to go to the one area in Santa Ana that is ok with dispensaries… areas that are not safe to begin with.

6. Let the market determine how many the city should allow.  Honestly, if Irvine has enough patients to support 20 dispensaries then that should be the number allowed.   If there isn’t a market for them then they simply will not last.  Basic supply and demand.

7. Allow them to make a profit and report that income to the state… and let them pay sales tax like any other business.

That is my two sense.

Dr. Breen

Posted in medical Marijuana Law
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Medical Marijuana and Autism; Prayer for Brandon

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

Often during the week I think about a 21 year old severely autistic patient that I took care of about 5 months ago named Brandon.  He is unable to speak, can be very violent when removed from his routine and needs round the clock care.  His parents were exhausted and at the end of their rope.   I remember how he was screaming in my office and violently banging the table.  It was extremely stressful to be around him even for 10 minutes.  I CAN NOT IMAGINE WHAT HIS PARENTS HAVE GONE THROUGH. WITH THAT I WANT YOU TO MAYBE SAY A PRAYER FOR HIM AND HIS FAMILY.

Brandon, I pray that marijuana helps you get though your day with a sense of peace and happiness.   I hope and pray that your parents can get some respite in the coming days, months and years as they take care of you.   I pray that God works a miracle in your life and helps you heal and get better.  Amen.

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A Medical Marijuana Doctor Reflects on “Perspective”; Life’s greatest gift

Posted By Dr. Sean Breen on August 14th, 2010

As a physician evaluating sick patients for medical marijuana recommendations I am constantly reminded to put my life in perspective.    It is one of the blessings that comes with being a physician.  Each day I leave my office I can honestly say “wow, things could be a lot worse” and quickly give my life perspective. Please read on.

I want to share with you some tools that you can use to help put your life in perspective.   But first let me tell you why I think you should even care or give any credit to my advice.

My life, generally speaking, has been pretty blessed but it has not come without significant challenges and life changing experiences.    I have worked very hard to get where I am and have studied “being successful at life” (whatever that means) for years.   I have been to seminars, listened to Anthony Robbins and experienced life.

At 29 I was sent to combat in Iraq with the Marines from Camp Pendleton.   I spent 9 months in 2003 getting shot at, taking care of the wounded and praying over the dead.  I have personally lost young Marines and Navy Corpsman in my arms.   I survived situations where I really felt like death was possible.   I have written letters to my family letting just in case I was killed.   I had to make difficult decisions regarding the care of the wounded.   Mentally it was grueling and surviving that experience made me mentally stronger and gave me incredible perspective.

As a physician I have seen life and death.   Each day in my office I speak to patients in horrific pain and many times know they are going to die very soon.

Like everyone reading this I have lost loved ones.   Some expectedly and some unexpectedly.

WITH ALL THAT SAID… I STILL CATCH MYSELF FEELING SORRY FOR MYSELF FOR A SPECIFIC SITUATION OR GET FRUSTRATED WITH EVENTS THAT ARE TAKING PLACE IN MY LIFE.   MOST OF THEM ARE LITTLE THINGS… CERTAINLY NOT LIFE OR DEATH.   A LAWSUIT, AN ARGUMENT WITH MY WIFE… WHATEVER.

What I have become very good at is quickly putting my life back into perspective.  I want to share with you a couple of tools that I use which really help go through the day with a healthy perspective.

Try this for the next 30 days: Each morning when you wake up ask yourself these 5 questions.   But the key is too really focus on the answers so that you feel the emotion.

1. What am I most grateful for in my life? Many times I think to myself “I am grateful I can get up out of bed without help and can walk to the shower without assistance.”    Or some days I think. “Thank God I have a bed to sleep on and running water to get a drink.    WOW DOES THAT CHANGE YOUR PERSEPCTIVE!  How often do you get frustrated because you really want your bathroom remodeled and wish you had a second sink in the main bath.  Or maybe it’s instead of “I hate having to get up and go to work”. Replace that with … “I am so grateful that I have a job and can provide for myself and my family”

2. Who do you love the most in your life? For me I think of all the people in my life that I truly love which makes me extremely happy.    If you can’t think of any person than maybe it’s ” I really and truly love God for what he has given me.”

3. What are you most excited about in your life? For me I think about my Son’s birth who is due on November 17th or a new goal that I set for myself.   If you aren’t excited about anything than you need to set one or two goals or accomplishments that can excite you about living.  THIS IS VERY IMPORTANT.

4. What are you most proud of about your life? For me I think about my service to this country or my medical degree.  For others it may be that “you took the high road in a family conflict or  stood up for something you believed in”

5. Who loves you in your life? Without knowing who you are reading this… I personally believe that God does love each and every one of us because he gave us life.   So if you don’t have anyone in your life that loves you for whatever reason… remember God each morning.  So maybe it’s “thank you God for loving me like you do.” I struggled at times in my life trying to figure out who God is or even what he is… but have put my faith in the fact that he gave me life… and if anything i am thankful for that.

If you can do this exercise each day for the next 30 days I believe you will be on your way to using perspective to improve your life.  Your emotional states can not help but changing for the better if you reflect on those five questions.

Lastly, I want you to realize that we are all seconds away from our deaths.   We have no idea when it is going to come or how.   Why would we focus on that… wouldn’t that just depress us you may ask?   Probably yes if thats all you focused on.    But how about this “right now someone is being told that they have untreatable cancer” . Really focus on that and how you would feel if that were you.   Focus on how your priorities would change.   Think about how irrelevant your money problems are… or how irrelevant it is that your spouse pissed you off  over something stupid.

In those moments when you are frustrated…. think this “Right now I am blessed with life and have this moment.  How lucky am I?”

No one gets through life without difficult trials and challenges.  The key is to gain a healthy perspective, no matter what the situation, about where you truly are and what you really have.

I hope this helps you in any way!

Be blessed,

Dr. Breen




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Has Medical Marijuana Blessed you Lately?

Posted By Dr. Sean Breen on August 13th, 2010

It’s interesting to speak to people about what they do for work in their life and whether or not they are fulfilled.   Today I had a patient who was an attorney and was the owner of a firm with 10 employees.  The reason he was here to see me because the “stress” of his job was “killing me.”  He was working 7 days per week and had 6 and 9 year old sons that he rarely spent time with. The bottom line was that he didn’t feel blessed with what he was doing with his life.   I thought about that for some time after he left and really felt good about working with patients who use medical marijuana.   They truly make me feel blessed in what I do everyday.

Being a physician can be an extremely grueling job and at times very thankless.   You work long hours doing your best to help patients and they leave your office cursing you for offering them “another pill”.   Very rarely does an internist get a hug and a thank you letter from a patient.

Amazingly, I have found that discussing medical marijuana with patients to be extremely rewarding.  Most are SO grateful that I am open to hearing their story and willing to let them try this medicine legally.   This week I must have had three patients send me thank you emails about their experience at my office. WOW!   That is awesome.

If you are thinking about getting into this specialty in any capacity… as a doctor, collective owner, educator or advocate I can tell you that it is very rewarding from a “feeling blessed” perspective.   I know that ultimately many patients are getting relief and their quality of life is improving.

With that…. be blessed today.

Dr. Breen

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Medical Marijuana and High Blood Pressure (Hypertension); Kidney Failure Patient

Posted By Dr. Sean Breen on August 13th, 2010

Today in my Irvine office I took care of a 36 year old male who suffers from complete Renal Failure (Kidney Disease)  and is on dialysis 3 times per week and is currently on the waiting list for a kidney transplant.   His kidneys failed because he had high blood pressure which went untreated for probably 10 years.    He uses medical marijuana because he has a very difficult time sleeping and also has a poor appetite as a result of regular dialysis.

I can not begin to tell you how important it is that you monitor your blood pressure and get it under control if it is high.   I see so  many patients (many in their 20’s and 30’s) who have high blood pressure but do nothing about it!! Many times they just do not want to take a medication or are not willing to eliminate the salt and caffeine out of their diet and start exercising.

The problem with walking around with high blood pressure is that your heart is being worked way to hard.  Because the heart has to pump blood against increased pressure in the blood vessels it becomes overworked, enlarges, requires more oxygen and ultimately fails.    The analogy I like to make is imagine driving down the freeway at 75mph in 3rd gear.  Your getting there but your engine is working WAY TOO HARD.   You need to put your car in 5th or 6th and take the load off the engine.   This is what dropping your blood pressure to 120/80 does for your heart.

Normal blood pressure is 120/80 (in that range) and it is considered high when either the top or bottom number hits 140/90.   Once it hits 140/90 and above you start to put a strain on your heart.

BUT WAIT; it is not only your heart that gets affected!!!   High blood pressure destroys your kidneys.   The increased pressure of the blood that is being filtered by your kidneys literally damages the tubes in your kidneys that filter out your blood.  IF YOU LET HIGH BLOOD PRESSURE GO UNTREATED FOR TOO LONG YOU END UP ON DIALYSIS 3X/WEEK WAITING FOR A KIDNEY TRANSPLANT.

Now lets just say that your kidneys do not get damaged and your heart is fine…. YOU STILL ARE AT RISK FOR HAVING A STROKE DUE TO AN ANEURYSM IN YOUR BRAIN.   The blood vessels literally get to the point where they “pop” (for lack of a more scientific word).  You lose oxygen to your brain cells and are now left having someone to wipe your butt the rest of your life.   NOT GOOD

My point of pointing these things out to patients is because I see so many patients who do not take their blood pressure seriously. They  continue to drink coffee, eat salt, drink beer and not exercise.   OR… they don’t want to try a medication “just because” they don’t want to be on meds.    Let me say one thing and please do not take offense to this.  YOUR DOCTOR COULD CARE LESS WHAT YOU DO.  HE DOESN’T THINK ABOUT YOU WHEN YOU LEAVE HIS OFFICE.   IT IS UP TO YOU TO MAKE AN INFORMED DECISION.    HE HOPES YOU TAKE HIS ADVICE BUT YOUR DECISION DOES NOT AFFECT HIM.

I really encourage you to take your blood pressure seriously.  If you have to be on a medication…. SO WHAT!   High blood pressure medications are very easily tolerated and you can take them every day for life and be fine.    The alternative is a heart attack, stoke or kidney failure…. ALL OF WHICH SUCK BIG TIME.

I’ll leave you with this. The number one cause of death is cardiovascular disease.   Not cancer, not accidents, not anything.

Now go take care of your blood pressure!

Be blessed,

Dr. Breen

Posted in disease treatment
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Medical Marijuana and The Banks vs The Mattress

Posted By Dr. Sean Breen on August 10th, 2010

It’s pretty amazing the lengths collectives/dispensaries have to go to make their business legitimate these days.  The state of California talks about all the revenue they are going to collect by taxing medical marijuana sales… but how can they do that when collectives and clinics are not allowed to open a bank account! Because marijuana is illegal Federally and the banks must comply with Federal law they are simply refusing to allow dispensaries to open bank accounts.

Not having a bank account creates plenty of problems for the state.  The first is that dispensaries have to go ALL CASH.  They can’t accept credit cards because the merchant account holders won’t open an account.   And banks won’t let them keep money there.   The result???  People are taking the money and stashing it “under the mattress”.

You tell me how the state is going to track revenue when they dispensaries deal in all cash and don’t have statements to show for any of it??  It is a rhetorical question obviously because there is no way for the state to track the money coming in and going out.

Personally, I had Bank of America freeze all of my bank accounts because they thought I was a dispensary…. when in fact I am a doctors office.  Unfortunate the name of my practice, Medical cannabis of Southern California, triggered some internal audit and with ones days notice they told me to pack up and go home.   Amazing but that is the reality.

So before we get all excited about potential tax revenue for the State lets fix the one major roadblock to collecting revenue… which is trackable accounts.

Posted in medical Marijuana Law
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Inherited Recessive Epidermolysis Bullosa and Medical Marijuana; An Alternative Treatment

Posted By Dr. Sean Breen on August 7th, 2010

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This photo is off a child who suffers from this disease.   Patients get blisters that can occur anywhere and typically all over the body as a result of trauma to the area (simple trauma like bumping your arm)    My patient today lost the ability to use all his fingers and toes because of sever scaring as a result of the blistering.  He ambulates primarily in a electric scooter but can walk a little bit at a time.

His blisters are extremely painful and he said he has a very hard time getting comfortable at night.   Not surprisingly all of the opiates (fentanyl, Morphine, Vicodin etc) his doctor prescribed did not relieve his pain and actually caused severe gastrointestinal symptoms.   He came in with his mother and told me that for the past three months he has tried medicating with cannabis to get some relief and to their amazement it has worked great.  He said it is the only thing that makes him comfortable.   They were so encouraged by our visit now that he and his Mother can safely access cannabis through a local collective.

Luke if you happen to stumble upon this blog… I want to tell you a few things.   Your positive attitude is amazing, inspiring and humbling.  You are a rock and it was truly an honor to take care of you.  I can’t imagine what you are going through and your positive outlook will make me a better person and doctor.   I left my office today with just such an incredible sense of gratitude for everything I have in my life and prayed that you find comfort and relief in your days ahead.    I hope and pray that cannabis continues to help you.   Thank you for coming into my life and truly inspiring me.  If there is anything else I can do please let me know!

Be blessed,

Dr Breen

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Proposition 19, Proposition 215, Senate Bill 420 and Medical Marijuana; How will this affect patients?

Posted By Dr. Sean Breen on August 4th, 2010

With November’s election approaching Californians have gained enough signatures to put proposition 19 on the ballot which would “legalize” marijuana for recreational use in the State.  I have blogged pretty extensively about this in the past but I want to focus on the difference between the current laws regarding medical marijuana and what the differences will be for patients who currently hold a medical marijuana doctors recommendation.

Amounts you can possess:

Currently Patients can possess as much medicine as they need to treat their symptoms.   In the past the limit was 8 ounces however the supreme court recently ruled that it is unconstitutional to put limits on the amounts of medicine patients can possess… as long as they can REASONABLY justify the amount.    Without a doctors recommendation you can only possess up to 1 ounce if prop 19 passes.

Where can you medicate?

Currently patients can medicate ANYWHERE SMOKING IS LEGAL. They just can not be within 1000 feet of a school, youth or recreational center.  You are also prohibited from medicating in a car, bus or boat.  Without a doctors recommendation you will only be allowed to medicate in your personal residence if prop 19 passes. MORE IMPORTANTLY it will be a FELONY to medicate in the presence of anyone younger than 18 years of age.   Patients with medical marijuana recommendations can medicate in the presence of anyone or any age.

Where can you purchase medication?

Currently patients can get cannabis from any legal marijuana collective/dispensary.   Collectives/Dispensaries will still ONLY BE ALLOWED to take care of patients with medical recommendations EVEN IF PROP 19 passes.   Recreational users will have to find legal businesses that sell marijuana.   Unfortunately prop 19 leaves it up to the individual city to determine whether or not they want to allow the sale of marijuana within its limits.  In San Diego they are already preempting prop 19 and have banned the sale of recreational marijuana.

How much can you grow? Currently patients can grow as many plants as they need to produce enough medicine for them to use.  The limit used to be 12 immature and 6 mature plants but that was declared unconstitutional.   Prop 19 only allows patients to grow in a 5′ x 5′ area which is much more restrictive.

Even if prop 19 passes the sale and possession of cannabis will still be ILLEGAL FEDERALLY.   Patients using the protection of Prop 215 will never have issues federally if they are staying within the limits and guidelines.

I think it behooves patients to continue to stay as a patient status and eliminate any confusion that prop 19 is going to cause if passed.


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Taxing Medical Marijuana;

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

As medical director for Medical Cannabis of Southern California I evaluate patients for medical marijuana recommendations full time.   I keep reading in the news about California and cities wanting to impose special taxes on the sale of medical marijuana.   Medical Marijuana should be taxed, but not at a higher rate than any other business or industry. This increased tax rate will only be passed on to patients.   Insurance does not cover medical marijuana so the burden is going to fall on patients which is not right.

An increase in the tax imposed on dispensaries will only fuel the black market for medicine where growers are operating under the radar and DO NOT pay sales tax.    I think what cities and the State needs to do is allow current dispensaries to operate FOR PROFIT so that they can show income and revenue.  They need to establish land use ordinances to determine how many they want in the city, allow them to get business licenses and pay taxes like everyone else.   Just treat them fairly!

Imposing a 10% tax rate plus and additional 2.5% like I have been reading about is going to be the nail in the coffin for many dispensaries.   The collective/dispensary business is not the cash cow that people think.   Most do not grow their own medicine and have to pay very high prices to get it from the growers.   Then there is a lot of competition which is keeping prices down.  The people who are going to suffer ultimately are the patients.

I similar example was the California Tax on cigars.   They decided that they were going to increase tax revenue by charging people who smoked cigars extra money.   Do you know what happened??  The local cigar shops got crushed because people now order them online from out of state to save the money.  The local cigar shops and the State of California are making $0.0 dollars on those sales.   Their thinking is counterintuitive and not effective.

Folks, before you get all excited about the increase in revenue your city is going to get you need to figure out what ultimately is going to happen by imposing higher tax rates on medical marijuana.

Posted in medical Marijuana Law
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