The study looked at 21 patients who took either long acting Morphine or pong acting oxycodone for chronic pain.   They then had them inhale medical marijuana using a volcano vaporizer for 4 consecutive days.    By the 5th day patients who used medical marijuana had a 33% reduction in their pain versus patients who used morphine or oxycontin alone.    In the pain management world that is a tremendous benefit.  What that means they concluded is that patients can most likely get away with taking less opioids and supplement with marijuana.    When you take into consideration how addictive opioids are and how many unwanted side effects come with their use, the potential savings to the medical community is huge.

As more and more studies like these continue to demonstrate the medical benefits of using medical marijuana are published it will be harder and harder for the federal government to keep it as a schedule 1 drug.     Medical marijuana will be in 50 states at some point in the very near future.  Once a large enough volume of patients start seeing the benefit of using it to treat pain it will be hard for politicians to ignore their voices and votes.

Although the tobacco and alcohol lobbyists are extremely powerful and influential, there will come a time when the voice of American people trumps their dollar bills.    I am not confident that it will happen in the next 10 years but by the time I die (hopefully not for another 50 years!) I think it will happen.

Many patients are not aware that they even qualify to use medical marijuana.  In California, there are over 150 different indications to recommend marijuana but the most common reasons people get recommendations for are:

1. Chronic Pain: for things like arthritis, headaches, back pain, dental pain etc.

2. Sleep disorders: primary insomnia to anxiety related sleep disorders.

3. Nausea, Vomiting or Lack of appetite for any reason.

4. Chronic anxiety in patients that do not want to take xanax or valium.

5. Har reduction for people who are addicted to opioids.

If you are wondering if you would qualify to use medical marijuana feel free to pre-qualify for free on our homepage or call our professional staff at 877-721-0047

At the end of my blog I include a basic patient handout that goes the basics about the disease.     My goal is to educate patients on the various uses of medical marijuana to treat a variety of diseases and symptoms.

In this case, my patient was able to stop 4 different medications as a result of using medical marijuana.

1. Tertabenazine:  he had been using this to control his chorea (involuntary muscle movements caused by damage to neurons. For example patients may flex their arms uncontrollably).   This medication also cause him to be nauseous and gave him occasional diarrhea.    Cannabinoids (medically active ingredient in the plant) are known to reduce muscle spasm.   I have seen it used in epileptic patients successfully to reduce the incidence of seizures.   In this case his involuntary movements were kept to a minimum by using an edible in the morning.   He preferred indica strains for this symptom.

2. Ambien: because he was in a wheel chair most of the day he had a lot of muscle soreness and made falling asleep very difficult.    He can now use medical marijuana instead of ambien to fall alsleep at night.  Typically he uses 2 doses of a indica dominant hybrid using a vaporizer 45 minutes prior to lying down.   He says that he now falls asleep within 20 minutes (on avg) of putting his head on his pillow.

3. Ibuprofen:  he used to use a lot of ibuprofen to regulate arthritis and muscle soreness from physical atrophy and being in a wheelchair.    The same edible he uses in the morning to control his chorea also eliminates his need for taking Ibuprofen.   We know that cannabinoids, specifically cannbinol (CBD), has potent anti-inflammatory effects on the body.   Growers of medical marijuana are trying to create high CBD strains to reduce inflammation while also lowering THC levels to limit the psychoactive effects.

4.  Anxiety:  patients with Huntington Disease, or any chronic debilitating disease for that matter, typically suffer from some level of depression and anxiety.    He has been able to stop xanax completely as a result of that same morning edible.

It is pretty humbling as a western trained physician to see patients eliminate 4 FDA approved drugs by using one simple plant.   It really does improve the overall quality of my patients lives.   Less money spent on drugs, fewer drug related side effects and a renewed feeling of being in charge of their lives again.

BASIC PATIENT INFORMATION:

What is Huntington disease? — Huntington disease is a disorder that causes people to move in odds ways and that can affect their mood and the way they think. In people with Huntington disease, nerve cells in a part of the brain die. The disease is passed on in families. If your mother or father has Huntington disease, you have a 50-50 chance of having it, too.

People with Huntington disease usually start to show symptoms between the ages of 40 and 60. Some people show symptoms much earlier.

What are the symptoms of Huntington disease? — The symptoms can include:

• Movements that you can’t control in the face, trunk, arms, or legs
• Feeling depressed, anxious, irritable, angry, or like you don’t care about anything
• Trouble interacting with other people
• Seeing or believing in things that are not there (called hallucinations)
• Trouble thinking clearly and forgetting things
• Weight loss

At first, the symptoms may be very slight, but they slowly get worse over time.

People with Huntington disease are at risk of suicide. If you feel sad or depressed, talk to your doctor or nurse about it. There are often treatments that can help.

Is there a test for Huntington disease? — Yes. There is a blood test to check for the gene that causes Huntington disease. Some people have this test before they show any symptoms. But if you are thinking of having this test, ask your doctor to send you to a genetic counselor before you have the test. A genetic counselor can help you learn about all the possible risks and benefits of having the test. For instance, a genetic counselor can help you find out:

• What the chances are that your kids will have Huntington disease
• How soon you might have symptoms, if the test shows you have the disease
• Whether you could have problems with insurance if the test shows you have the disease

How is Huntington disease treated? — There is a medicine that helps with the movement problems caused by Huntington disease. It is called tetrabenazine (sold as Xenazine®). If it doesn’t work, there are other medicines that can help with movement.

There are no medicines that deal with all the symptoms of Huntington disease. But there are lots of treatments to help with specific symptoms. For instance, people who are depressed or anxious can take depression and anxiety medicines. Likewise, people who see things that are not real can take medicines to deal with that problem.

People with Huntington disease sometimes also use walkers, wheelchairs, or other devices that can help them manage their problems. Plus, they sometimes work with physical or speech therapists to learn special exercises that can help them manage.

Unfortunately, there is no cure for Huntington disease. Most people die 10 to 30 years after the symptoms begin. If you have the disease, talk to your loved ones about the type of care you would like to have when you get really sick. That way they will know what to do, even if you become unable to speak for yourself.

What if I want to get pregnant? — Talk to your doctor nurse before you start trying to get pregnant. If you are taking medicines, you might need to switch to different medicines that are safer for a baby. You also might want to talk to a genetic counselor about the chances that any children you might have would develop Huntington disease.

Over the past decade there has been a plethora of research about the dangers of using non steroidal anti-inflammatory drugs (NSAID’s).  Celebrex, Motrin, Naprosyn taken regularly can increase the chance of having a fatal cardiovascular event (heart attack or stroke).   In addition they frequently cause bleeding the stomach and intestines due to ulcers.     Merck took Vioxx off the market after it was exposed for hiding data (allegedly) that showed it increased patients risks for heart attack and stroke.  People are very skeptic of the pharmaceutical companies and are tired of spending money on medications that can have serious side effects.

This is where medical marijuana is perfect.   Patients can substitute a bunch of medications for a plant that not only reduces pain but also decreases inflammation (both the hallmark of arthritis).    It does so by binding to the nerves themselves in addition to the cells in the immune system, thus reducing inflammation.

Everyday I take care of patients with rheumatoid arthritis, psoriatic arthritis, osteoarthritis of the knees, degenerative disc disease in the spine etc.   On most occasions, patients can limit their prescribed medication use to only a few times per week.

Scientists believe that the active ingredient in the plan that helps reduce inflammation is cannabinol (CBD).   This is opposed to the ingredient people are most familiar with, tetrahydrocannbinol. THC is the main psychoactive ingredient but not the main one that reduces inflammation (per current knowledge).

The biggest downside to using medical marijuana for elderly patients is the risk of falls because cannabis can affect a patients balance, coordination and motor skills.   So it must be used safely until the patient get a hang of it.    After a few days most patients are much more comfortable with its side effects.

If you would like more information on how medical marijuana can help you feel free to contact our office at 877-721-0047.

Dr. Breen is Navy trained family doctor and spent 4 years (2002-2006) as a Battalion Surgeon with 1st Marine Division at Camp Pendleton.   He is a decorated combat veteran and spent 9 months (Jan-Sep 2003)with 1st battalion 4th Marines in Iraq.   He brings his military training and much needed professionalism to an industry that is struggling to find standards of care.

Dr. Breen states that he see’s a lot of Veterans who are benefiting from medical marijuana.   The most common reasons his patients receive medical marijuana cards is for 1) Chronic Pain 2) Insomnia, PTSD, Anxiety 3) Chemotherapy treatments 4) HIV AIDS   In addition he sees patients with a variety of conditions.

Medical marijuana is best known for it’s ability to reduce nausea and stimulate the appetite.  However it has also been studied extensively to reduce pain (especially neuropathic pain), reduce inflammation, reduce muscle spasms of any kind, reduce anxiety, improve mood, reduce intra-ocular pressure in glaucoma, and assist with end of life care.

Dr. Breen has blogged recently about 2 cancer patients who were able to stop 6 different medications when they started using medical marijuana.

Dr. Breen see’s patient in his Long Beach office Monday, Wednesday and Friday and is also in Irvine Tuesday, Thursday, Friday and Saturday.    If you would like more information feel free to call us at 877-721-0047.

Our address is: 1777 N Bellflower Blvd Suite 212, Long Beach CA 90815

RSD is a chronic pain condition that typically follows soft tissue injury or surgical procedures.   The pain is often severe, chronic and described as stabbing or burning.   Patients report that light touch creates a severe pain that is out of proportion to event.   For example, brushing up against a person who has RSD may cause a pain that causes them to “shoot through the roof.”

(AMAZINGLY: IN THE MIDDLE OF WRITING THIS BLOG A NEW PATIENT CAME IN WITH THE DIAGNOSIS OF RSD!.  THAT IS 2 IN ONE DAY AFTER HAVING ONLY 3 IN 4 YEARS OF PRACICE).

This new patient was a 24 year old US Marines who fractured his wrist while deployed in Iraq and had surgery to repair it.   He then had to have corrective surgery for hardware failure.   It was after this second surgery that he developed RSD.   He described the pain as burning and severe.   Like my first patient, light touch  causes severe pain.   He has been using medical marijuana for the past 2 years after trying lyrica, effexor, gabapentin (neurontin), oxycontin, vicodin and percocet.   He was able to stop all of them and just use medical marijuana.

OK back to RSD.   The pain is caused by an overactivity of the nerves to the affected area.    It is very often misdiagnosed, incorrectly treated and patients suffer greatly.   Loss of work (only 1 in 5 can go back to their normal work routine prior to being diagnoses), depression, insomnia and suicidal ideations often follow the symptoms.    My Marine patient said he was “blown off” by doctors for 2 years after he starting having the symptoms.   I would guess that is because they did not consider the diagnosis.

Treatment of RSD is very difficult.   Typically patients try a many different medications:  everything from NSAIDS (motrin, celebrex) to oral steroids (prednisone) to anti-depressants, anti-convulsants, anti-oxidants (the list goes on).      I have found very little research of using marijuana to treat RSD but the stories of my three patients is certainly promising.

Medical Marijuana is an NMDA Receptor Antagonist

Although we do not know the exact mechanism of how medical marijuana reduces pain in RSD, I personally believe that its central affects on the NMDA receptor (NMDA receptor is the main receptor for the excitatory neurotransmitter Glutamate) have something to do with it.    I recently went to a lecture by a world renowned neurologist who is studying the effects of cannabis on the NMDA receptor.

Regardless of the mechanism, the one thing that I do know is that in some patients (all 3 of mine), it works!   They have all been able to use significantly less traditional pain medication and it has improved their day to day lives tremendously.

I recently reached out to the national headquarters for RSD research and asked them if they have seen results in other RSD patients using cannabis and am waiting for their answer. Certainly this is exciting news and if any patient reading this suffers from RSD/CRPS please feel free to contact me to see if medical marijuana can be of some benefit to you.

Be blessed,

Step 1: Determine if you have a qualifying diagnosis
Most patients think medical marijuana can only be recommended for dying patients or those with severe disabilities. In California, that is not the case. The most common reasons patients receive a medical marijuana card are:

a. Chronic Pain: any condition where chronic pain is a component can qualify. For example, back pain, joint pain, post-operative pain etc.

b. Muscle spasms: can be for many reasons but things like Multiple Sclerosis, Restless Legs Syndrome

c. Nausea and Poor Appetite

d. Insomnia and Anxiety

e. Mood disorders such as depression.

f. Inflammatory bowel disease including Irritable Bowel Syndrome: Crohns Disease and Ulcerative Colitis

***There are over 250 indications that we can recommend cannabis for. You can simply call our office and find out if your diagnosis will qualify. 877-721-0047

Step 2: Gather your medical documentation.
When you see a doctor for medical marijuana he will need to review your medical records and verify your diagnosis. You can simply contact your treating doctors office and ask that they release your medical records to you. They simply have you fill out a form.

Step 3: Locate a doctor that is specialized in recommending medical marijuana
Dr. Breen has extensive knowledge about the medicinal benefits of using marijuana and will be able to answer any questions you may have. Visit our website at www.MCSoCal.com and see our office locations in Irvine, CA and Long Beach, CA

Step 4: Simply bring in your documentation.
At your appointment Dr. Breen will review you medical records, go over all the benefits and risk of using medical marijuana, perform a physical exam and then determine if it is an appropriate treatment approach.

Step 5: Purchasing your Medicine at a Medical Marijuana Dispensary
Doctors are not allowed to provide you with the medical marijuana so you have to go to a local medical marijuana dispensary. You will need to bring your written recommendation signed by Dr. Breen They will make a copy of it and verify your eligibility by using our 24 hour online verification system. You can then purchase up to 8 ounces of medical marijuana.

The process is as simple as that. Dr. Breen and the staff of MCSoCal will make sure that all your questions are answered before your leave our office. We realize that for many patients this is a very new experience and can be nerve racking. We want to assure you that your doctors visit will be very professional and compassionate.

Thanks for visiting our site and reading our blog.

MCSoCal Staff

When the surgeon came in he took a look at his MRI and within 2 minutes said:  ”The only way you are going to get better is if you have surgery and only 50% of the people who have this surgery improve, and some even get worse.”    If he didn’t want to have surgery the surgeon recommended he see a pain specialist and start a regimen of opiate narcotics to control his daily pain.

Unfortunately Brian had a brother who suffered from opiate addiction and using opiates was not an option for him.   He left that visit feeling demoralized.  The thought of having to live with this pain was too much, the thought of having surgery overwhelming and the fact that modern medicine had no other viable options for him was flat out depressing.

It was later that day that he ran into a colleague who had been using medical marijuana for similar pain.   His colleague convinced him to try and two years later he is still able to manage his pain and stay out of the O.R.

When I spoke with Brian today and asked him how the marijuana was working his response was “For the past two years it has saved me from back surgery and kept me off opiates so I am doing great”.  Although his pain is not cured it is manageable.  He is back at work full time and functioning.

There ARE other options for Brain.   Acupuncture is my favorite treatment approach for chronic pain.  In addition, a good osteopathic physician can certainly work with soft tissue to eliminate fascial strains and improve circulation.

In the meantime Brian can continue to live a productive life.   Medical marijuana has been a Godsend for him.   He uses a vapor genie vaporizer at the end of the day with an indica strain that relaxes his muscles without producing a sever “high”

If you are suffering and would like relief feel free to contact me at any time.

Be blessed,

I first noticed this patient because he was sitting in my waiting room with no shoes or socks on and his feet up on the coffee table which seemed a little odd until I saw his feet… and then I understood.  To see a picture of what I witnessed and what someone who suffers with this disease has to deal with READ ON…

I tried to copy and past the photo but couldn’t!!  Simply google search “Picture of Erythromelalgia” and you will witness this terrible disease.

This disease is cause by changes in the physiology of the neurons that are responsible for pain (nociceptor).  What it does is cause the nerves to be super sensitive and the slightest sensory change can trigger them to fire.   Specifically (if you are medically trained), it decrease the threshold of depolarization of gated sodium channels.

What does this mean for patient?  The slightest thing can trigger severe pain.   Heat, pressure (socks/shoes), spicy foods, alcohol, mild activity, stress and insomnia are all common triggers for a painful attack.   Pain can be excruciating, burning and does not typically respond well to traditional “pain pills”.

This disease also effects what is called the sympathetic nervous systems regulation of blood vessels.  It actually causes them to stay overly dilated which gives the skin an extreme red color.    Not only were my patients feet beet red but his toe nails were black from the damage and constant change to the small blood vessels.

Treatment is symptomatic only meaning that there is no cure as of yet.   Things like avoiding heat, elevating the feet (hense the reason my patients feet were on the coffee table), cool compresses and other pain medications are typically used.

None of these treatments are that effective and patients are left to fend for themselves.

This disease it genetic in an autosomal dominant transmission.  It is more common in women and typically is diagnosed after age 50.   Many times patients will have seen 7 specialists before an accurate diagnosis is made.   It is for this reason that patients can become depressed and frustrated.  AMAZINGLY, my patient did a symptom check on the Mayo clinics website… and low and behold “Erythromelalgia” popped up.    He then called the doctor and said “I think I have erythromelalgia” and his doctor said “I think you are right.”  HE DIAGNOSED HIMSELF!!

This is a pretty uncommon disease and is not something physicians see often.  It affect 1.2/100,000 males and 2.0/100,000 females. There is no diagnostic test for it.

Interestingly he said medical marijuana provided significant relief.   He was using an indica strain called OG Kush in the evenings and it allowed him to sleep soundly.   He also has not had to use any opiates since starting marijuana.   I consider this a success story and for this patient marijuana has “saved my life” (in his words)

It is stories like this that I get so excited to be able to speak to patients about using medical marijuana.

If you are suffering from this rare disease and would like a consultation feel free to come in and see me.

Be blessed,

I always thought is was silly in medical school to have to memorize the mortality and prevalence rates for diseases.   For example, 1/6000 kids will get autism.  Or 95% of patients with pancreatic cancer will die in three years.    As a clinician it really doesn’t do me any good.   I would often joke with my classmates and say “I’m sorry MR Jones but you are one of the unluckiest people on the planet… only 1 in 300,000 people will get what you have.”

I often tell people that the body has never read a textbook nor has it read a statistic.  Never give up on your mind and body wanting to heal.  IT DOES!   When you put a number like 5% survival rate in your head you already have lost the battle.   What I commonly tell patients is to visualize themselves completely healed every day.   Actually try and recreate the feeling of being disease free and let it be as real as possible.  Do not ever underestimate the bodies innate wisdom and healing powers.

“Ye have faith in a grain of mustard seed, nothing shall be impossible unto you”