This study comes off the heals of another study that showed using NSAID’s increases a patients chance of having a heart attack or stroke.     Atrial fibrillation is an arrhythmia (abnormal heart rate) where the heart rate is generated from multiple areas of the top two chambers of the heart (atria).  It can have sever life threatening consequences if not treated.    Typically it is treated with medications that reset the heart beat or even electrically shocking (cardioversion) the heart back into normal rhythm.

More commonly people think of the risks of bleeding in the intestinal tract or liver damage when using these medications over time.   It was for this reason that drug companies produced the COX-2 inhibitors (Vioxx and Celebrex) only to find out that they too increased the risk of stroke and heart attack.

All of these studies strengthen the recommendation for patients to substitute using medical marijuana for chronic pain and inflammation for these potentially dangerous drugs.   If used in small medical doses, patients can experience pain relief without having to experience the severe high associated with recreational use.   Medical marijuana seems to reduce inflammation by influencing the cells that are responsible for the inflammatory response.  They bind to CB2 receptors in the immune system.   This mechanism needs to be explored further but you can’t ignore the plethora of patient reports of pain relief with marijuana use.

What seems to be irrefutable is that medical marijuana does not cause any of the severe side effects or potentially dangerous cardiac events that NSAID’s do.  Cannabis ha been used by millions of people recreationally in high doses for many years and we do not see any evidence of severe major organ damage.

So before you decide to pop four 200mg Motrin because of your knee pain, think about using marijuana as an alternative.

It is times like these that I wish there truly was “karma”.   If that were the case Governor Christy would develop severe migraines, his wife would develop breast cancer and his son would develop an opiate addiction secondary to taking oxycontin for pain.   I would then wonder if he would try to derail New Jersey’s medical marijuana law.  Would he still want to limit the concentration of cannabinoids and hence its potency?  Would he outlaw the ability for collectives to deliver medicine to a terminally ill patients home?  Would he try and limit the ability to grow it to one or 2 locations in the state?  I HIGHLY doubt it.

To the contrary, medical marijuana would  be accessible to every patient in need… probably yesterday.   He would be searching the most potent strain he could find and for the cheapest price.   His family would have the largest personal grow in the State.

But like most politicians, he is a pussy.   He is too afraid of what his constituents are going to say out of fear of losing re-election… and in turn is being dishonest.

I PROMISE you that is the Governor had a migraine that was not effective treated with Imitrex, Maxalt, Tylenol, Motrin,, Vicodin etc… he would be the first appointment in my office tomorrow morning.  And he would be begging for relief so that he can actually function.

So I guess I take some offense to being called a “quack” for recommending cannabis to headache patients.     It is just frustrating professionally because I get to hear from hundreds of patients every month about how their lives have been changed for the better because of this plant.

Governor Christy you suck.   New Jersey will go backwards under your “leadership”.

I’m probably much easier to reach than you are.  Feel free to give me a call at 877-721-0047 and I would happy to enlighten you.

Here is the link to the article about the study.

http://pagingdrgupta.blogs.cnn.com/2011/01/11/risks-of-nsaids-backed-in-new-study/?hpt=Sbin

From there you can access the actual study itself if you choose.

The bottom line is this.   We are not 100% sure of the safety of these medications.  This study looked at over 116,00 patients which is a huge number.  The most considerable risk was for patients using motrin (ibuprofen) regularly.   It showed an increase in the risk of stroke.

The question becomes: Is cannabis a realistic alternative for you?   Obviously cannabis has it’s limitations.   You can’t use it and drive or work.   So if you have achy joints when you wake up and have to go to work… you are going to have to look for an alternative.   Also, because cannabis is psychoactive (affects your judgement, concentration, short term memory), many people will not be able to use it and function at 100%.  This is a concern for parents who have to take care of younger children.

However, if you can use it safely and responsibly I have found that patients get tremendous relief of joint pain, muscle spasms and it allows them to sleep soundly.     Cannabis has NOT been shown to be toxic to any of the major organ systems.   One of the things you have to consider (if you are along term pain patient) is what are the risks and benefits of using cannabis and if you choose not to…. what are the risks and benefits of using NSAID’s and other opiate narcotics. I think what you will find is that if you are in chronic pain and there is not much western medicine can do for you…. that at least TRYING cannabis is worth a shot.

Darvocet is an opioid narcotic used to treat pain.  It is the same class of drugs as percocet, vicodin, hydrocodone, oxycontin etc.   It was approved by the FDA in 1957 and has been regularly prescribed for pain in around the world.  DOCTORS CONSIDERED IT SAFE BECAUSE THAT IS WHAT THE PHARMACEUTICAL COMPANIES THAT STUDIED IT SAID.

WELL ONCE AGAIN THE MEDICAL COMMUNITY GOT IT WRONG.  And in this case patients died because of it.    IT IS FOR THIS REASON THAT SO MANY OF MY PATIENTS COME IN AND TELL ME “I WANT OFF MY PAIN PILLS AND WANT TO USE SOMETHING MORE NATURAL AND SAFER”… HENSE THE REASON MEDICAL MARIJUANA IS THRIVING RIGHT NOW.

Time and time again in medicine our current practice standards turn out to be detrimental to the overall health of women.   And not often enough do physicians look at the overall nutrient depletion effect of prescribed drugs.  It is shocking to hear how many patients are given prescriptions like they are nothing at the drop of a hat when they tell their doctor they have pain.

Opiate narcotics (“pain pills”) are not safe to take long term.   They are addicting, nauseating, constipating and can cause respiratory depression and death.    More and more patients are developing opiate addictions and more doctors are prescribing them.  I have come to realize that the majority of MD’s have no other arrows in their quiver when it comes to pain management.

To the contrary, osteopathic physicians can also treat using physical manipulation or energetic medicine to reduce pain (i.e cranial-sacral therapy).  Acupuncturist use the bodies energy to treat pain.  Chiropractors use physical manipulation and soft tissue techniques to reduce pain.

Where does cannabis (marijuana) fit in?   Cannabis is used by thousands of patients to get off all the opiates and NSAID’s (i.e. motrin, naprosyn) medications that are riddled with side effects.

Cannabis has been shown, in small doses, to significantly reduce pain in patients.   It does so by binding to CB1 receptors located in the central and peripheral nervous system.    It actually mitigates the pain transmission.  Unlike opiates, it is not addicting, you can not overdose and it is not toxic to any of the major organ systems.   It can be vaporized in very small doses safely.

Time and time again we here about drugs that are commonly prescribed all of a sudden being unsafe!  Vioxx (for arthritis), glyburide (for diabetics), HRT (hormone replacement therapy- NON bio-identical), Darvocet (for pain) and NSAID’s (increased cardiovascular risk).   These are drugs that physicians were told by big pharm that they were tested and safe!

My advice to patients: try every non drug/surgery treatment option prior to starting medication UNLESS withholding drug/surgery poses an immediate risk to your health.

Many patients who suffer from pain experience this same regimen of medications.   All of which may work temporarily but none of which are a good long term treatment plan.  Overuse of ibuprofen leads to stomach and intestinal ulcers and bleeding, heart attack and stroke (potentially).  Overuse of vicodin leads to addiction and dependence, constipation, nausea, itching and mental status changes.  Prednisone, although initially will limit inflammation, will cause many sever side effects (hyperglycemia, osteoporosis, weight gain, psychosis, increased appetite, depression/anxiety, infection due to weakening of the immune system, easy bruising, fatigue).

Amazingly, I expect this patient to get off ALL of these medications and use cannabis daily.   THIS WILL SIGNIFICANTLY IMPROVE THE OVERALL QUALITY OF HIS LIFE.   Eventually, hopefully, he will be able to use cannabis sparingly and be pain free.   BUT, if he has to use cannabis every day the rest of his life… no big deal!   Compared to these other drugs it is much safer.  He can not overdose, it will not cause ulcers and it does not effect any of the major organ systems like these other medications do. If used daily, we just recommend every few months giving your body a break for 5 days or so.

70% of my practice is taking care of pain patients.    Medical marijuana, when used in conjunction with Osteopathy, Chinese Medicine (acupuncture), physical therapy and meditation/prayer, is a highly effective and good long term treatment plan.

For more information about how to make an appointment to see me call my staff at 877-721-0047 and come on in.  We have offices in Irvine and Long Beach California.

Be blessed,

Dr. Breen

http://www.cbsnews.com/8301-504763_162-20015148-10391704.html

Although the study had only 23 patients in its pool I think their findings align with my conversations with over 5000 patients who I have treated for chronic pain.

The reason why cannabis works to control pain is because our body harbors receptors to the medical active ingredients in the plant (cannabinoids) throughout our nervous system.   Specifically the brain, spinal cord and peripheral nerves.   Researches identified these receptors in the mid 1990′s and also identified a cannabinoid called anadaminde that our body produces naturally. This was a significant finding as it gave validity to the stories of patients who state that cannabis is just as effective as any narcotic in treating pain.

One of the advantages that cannabis has over other pain medications is that it does not have the serious side effects that you get with NSAID’s and opiates (Vicodin, Oxycontin, Percocet, Morphine, Fentanyl).   Specifically cannabis is not addictive, does not produce nausea and constipation and also is not going to tear a hole in your digestive tract or shut down your liver.   In fact if NOT smoked cannabis has not been shown to be toxic to any of the major organ systems.   ALL OF THESE ATTRIBUTES AD UP TO AN IMPROVED QUALITY OF LIFE…. IMMEDIATELY.

Today in my Irvine office I had 17 patients, 12 of which requested evaluation for chronic pain from a variety of disorders.   One man had daily headaches with nausea for the past 2 years.  Another women suffered from severe menstrual cramps.    I had one 61 year old mother who was hit by a drunk driver going 90mph in 1985 and shattered her pelvis and lumbar spine.   She has been using cannabis daily for years to help her get to sleep and reduce the pain after work.

Many of you reading this have no idea that you can get relief for chronic pain using medical marijuana (cannabis).   You DO NOT HAVE TO SUFFER LIKE YOU CURRENTLY ARE ANY LONGER!  Simply contact our office to come in and receive a recommendation to use medical marijuana.  You have nothing to lose.  If it doesn’t work than simply do not use it.   If it works then GREAT!

I have offices in Long Beach and Irvine and you can contact us by calling 877-721-0047 or through our website at www.MCSoCal.com

Be blessed,

Dr. Breen

I am often amazed by just how much NSAID’s are used in traditional medicine to control chronic pain.    When I was a military doctor with the Marines corpsman often handed out 800mg Motrin like they were candy.    And older patients who suffer from arthritis and other joint pain regularly rely on these medications to reduce inflammation and pain.    I don’t think the average person understands the underlying risk of taking these medications regularly.

NSAID’s work by reducing pain and also by limiting inflammation.    Recently there have been some solid studies on the increased risk that they pose to patients if used chronically.    Specifically, they have been shown to increase the risk of heart attack and stroke in healthy patients.   This study: http://www.renalandurologynews.com/nonaspirin-nsaids-may-raise-rcc-risk/article/146731/      demonstrated an increased risk of Renal cell Carcinoma.   My patients Nephrologist and Oncologist directly related his cancer to his use of medications.

Medical Marijuana has been shown to both reduce inflammation and pain in people who have chronic pain.   Its benefits have been demonstrated even in lower doses which is great for patients who do not want to feel the “high” with use.   Many of my patients just need to vaporize a small amount of a less psychoactive strain such as an indica like afgan kush.    It has more of a body affect and is more relaxing and sedating than some of the sativa strains.

If you would like more information about the use of medical marijuana feel free to contact me by calling 877-721-0047 or through my website at www.mcsocal.com

Be blessed,

Dr. Breen

For those of you reading this who have no idea what gout is let me give you the basics.  Gout is an acute arthritis that occurs from the build up of uric acid in the blood.   Uric acid is produced in the breakdown of purines (high protein foods) and other nucleic acids.   There are many foods that we eat that are high in purines.  Alcohol! Meats, Fish, Lentils, Beans, Spinach and a few others. There are also medications that lead to the build up of uric acid in the blood.  Diuretics (for blood pressure), low dose aspirin, and niacin.   Either one of two things leads to the build up of uric acid.  Either the body is overproducing it or the kidneys are not excreting it adequately.   So patients with kidney disease can have issues.

What happens is the uric acid builds up and crystalizes in the joints.  Typically it affects the joint of the big toe (1st MCP joint).  Attacks can be extremely painful and the joint will become severely inflamed.   Typically doctors will treat acute attacks with high dose NSAIDS like alleve, motrin or indomethicin.  The problem for many patients is that they can not take NSAID’s because of the side effects.

Cannabis contains over 60 medically active ingredients that we know of.   Collectively they are called cannabinoids of which THC is only one of the them (the main psychoactive ingredient).   We know that we have receptors to these cannabinoids in our nervous system (brain and spinal cord) which are responsible for its analgesis(pain reducing) properties.   We also discovered that we have receptors throughout our immune system (spleen and certain immune cells).  It is by this mechanism that we suspect cannabis can reduce inflammation.

The interesting thing about cannabis is that patients experience many different effects.  Some patients state that they still feel the pain but “don’t care or focus on it as much” and some patients clearly state that the pain is reduced significantly.   I would imagine that there is both a reduction in inflammation in addition to an increased pain thresh hold via a direct  effect on the nerves themselves.  Regardless, cannabis has very few unwanted side effects.     It is not toxic to any of the major organ systems (if not smoked) and there is next to no chance of physical addiction or overdose.

Although most patients do not want to experience the psychoactive effects of cannabis (euphoria, loss of coordination/balance, short term memory loss) I had an 89 year old female patient today who told me that “it actually makes me feel happy!”  She suffered from debilitating pain and the vicodin was no longer working for her.    In comparison to opiate medications it does not cause nausea, constipation, lack of appetite or addiction.

In the end I always tell patients “if this is something that improves the quality of your life… use it!  If not, then simply don’t use it.”  Most people will find SOME benefit.  Improved sleep, less pain, less anxiety, a little better mood, improved appetite etc.

If you would like to be evaluated by me to see if you could benefit from using cannabis I would be happy to take care of you.  Simply give us a call at 877-721-0047 or contact through our website at www.mcsocal.com

Be blessed,

Dr. Breen

The hallmarks of carpal tunnel syndrome are pain (burning, tingling, numbness) and inflammation with use of the wrist as a result of compression of the median nerve which is one of the nerves that goes to your hand (specifically the thumb, index, middle and half of the ring finger and the palm next to the thumb) Most commonly it is tied to overuse (repetitive motion) involving the affected wrist.    The pain can cause significant discomfort with loss of sleep and also loss of the ability to perform simple tasks pain free.  Other causes can be physical abnormalities (bone spurs, tumors, old healing fractures) and some systemic diseases such as diabetes or rheumatoid arthritis.

Typically patients are treated with immobilization (splints) for 2-6 weeks and NSAID’s such as ibuprofen.    The main goal is reduce the amount of inflammation.    If rest and NSAID’s do not work orthopedic surgeons will sometimes perform corticosteroid injections to reduce inflammation.  If that fails then surgery can be recommended.

However, I typically recommend that patients use medical marijuana to help reduce pain, reduce inflammation and improve sleep  as an alternative to NSAID’s and sleeping pills at night. If patients work during the day then NSAIDS can be appropriate as it is illegal to drive and use cannabis.

Marijuana is a great medication for sleep.  Patients typically only have to use very small amounts of an INDICA strain which is much less psychoactive.   Meaning they don’t have to experience the “high” that most patients associate with marijuana use.    It can be vaporized 20 minutes prior to lying down.  Patients using the vaporization method are NOT exposing themselves to any smoke and there is next to NO SMELL.

The cannabinoids in the plant also act as potent anti-inflammatory agents.   Therefore any inflammation of the tendons (attach muscle to bone vs. ligaments which attach bone to bone) will also be reduced thus relieving the patient of their symptoms.

In light of continued studies showing an increase risk of heart attack and stroke in patients who regularly take NSAIDS (such as motrin/ibuprofen/diclofenac) I highly recommend limiting the amount of medications that you take.

If you have any questions about medical marijuana and want to see if you can benefit from it’s medicinal use feel free to give us a call at 877-721-0047 or pre-qualify for free online at www.mcsocal.com

Be blessed,

Dr. Breen

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