Posts Tagged ‘peripheral neuropathy’

Marijuana as alternative to Lyrica (Pregabalin) for Peripheral Neuropathy

Posted By Dr. Sean Breen on June 2nd, 2010

Today I evaluated a 54 y/o HIV+ male who suffered from diabetic peripheral neuropathy for medical marijuana as an alternative to Lyrica (pregabalin)  He reported that he had developed the diabetes as a result of treatment with protease inhibitors for his HIV.  He has been experiencing numbness and tingling in both his feet for the past 6 months as a result of the neuropathy (pain originating from damage to the nerves themselves).  He stated that he wanted to stop taking the Lyrica because of a 50 lb weight gain associated with the medication (weight gain is a common side effect).

Marijuana has been studied pretty extensively for patients suffering from neuropathic pain.   UCSD Cannabis Research Center recently completed a study about the beneficial affects of cannabis for peripheral neuropathy.   It showed that even in low doses cannabis can reduce the pain associated with diabetic and HIV associated neuropathy.

This patient had been using cannabis for the past two weeks without the Lyrica and reported a greater reduction in his overall symptoms.  In addition it improved his sleep which had a huge impact on his day to day life.  He was no longer groggy throughout the day and his work productivity improved.

Interestingly he found an indica strain of cannabis that did not stimulate his appetite which would have been counter-productive.  Some strains of cannabis are more likely to increase a patients appetite.

In my practice I see all types of chronic pain patients who benefit from cannabis.  If they are using another medication and not seeing the results they need or are having too many unwanted side effects then it is definitely worth it to give cannabis a try.   Most patients do extremely well and can stop taking their prescriptions within a few weeks.

If you would like to learn more about getting a medical marijuana evaluation so you can legally use cannabis in California feel free to make an appointment by calling 877-721-0047 or visit us online at www.mcsocal.com and pre-qualify for free.

Dr. 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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Diabetic Neuropathy, Neuropathic Pain and Marijuana (Cannabis): An Alternative Treatment

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

As medical director for Medical Cannabis of Southern California I often evaluate patients who suffer from neuropathic pain as a result of diabetes.  Neuropathic pain means pain that is associated with direct pathology to the nerves themselves.   This is in contrast to pain in a muscle whose signal is transported to the brain via the healthy nerves.   In diabetes the elevated levels of sugar in the blood actually cause damage to the nerves leading to chronic pain.   Cannabis has been shown in several studies to reduce the pain associated with various causes of neuropathic pain including HIV neuropathy.

Typically diabetic neuropathy starts by affecting the peripheral nerves to patients feet and legs.  They can experience sharp pain when walking, decrease sensitivity to temperature, tingling, numbness and eventually when the nerves because completely destroyed no feeling at all.  I once took care of an elderly women with severe diabetic neuropathy who fractured her ankle to the point where her tibia was protruding directly through her skin.  Basically it snapped in half.  Amazingly she felt NO PAIN because her nerves were destroyed.

Many patients get put on medications such as gabapentin (neurontin), narcotics like vicodin and even anti-depressants such as amitryptiline.    Most patients report very little relief in their pain but also have unwanted side effects.   They report a significant reduction in their pain with even small doses of cannabis.   They can use it as often as they need without any fear of overdose, addiction or end organ damage.  They also can medicate using a digital vaporizer which makes it odorless and smoke free!

If you would like more information on cannabis and chronic neuropathic pain or would like a consultation please give us a call at 877-721-0047.  Dr. Breen has offices in Irvine and Long Beach California.


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Alternative Treatments for Neuropathic Pain; Cannabis (Marijuana)

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

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

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

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

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

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

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

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

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