1. Long Beach: plans to shut down ALL medical marijuana dispensaries 8/12/12 which is when their ban goes into effect.    Unfortunately the city council voted 8-0 to not extend the grace period to the original 18 dispensaries that won the lotto and were in full compliance with city ordinance.  

2. Costa Mesa: Robert Martinez, owner of two medical marijuana dispensaries, obtained 6800+ signatures to get an initiative on Novembers ballot to ALLOW medical marijuana dispensaries to operate as storefronts in the city of Costa Mesa.    If the voters pass this, MMJ dispensaries will be allowed to operate freely and the city will NOT be allowed to use federal resources to shut down legal dispensaries.

3. Santa Ana:  Continues to be the main “hub” for finding quality dispensaries.   With closures in Lake Forrest, Costa Mesa and the majority of south Orange County, patients are forced to drive to Santa Ana, Garden Grove and Anaheim.

4. Delivery services multiply.   Many of the storefront dispensaries that were forced to close simply contacted their patients to arrange for regular delivery. Unfortunately, many new patients do not prefer this method as they are concerned about strangers coming to their homes.

5. Los Angeles:  New surprises here as the city votes 14-0 to ban all collectives.  We will see if they enforce this.    My guess is that they will shut one down and 2 will open up.    They are going to have to bring in the Feds like the cities of Costa Mesa and Lake Forrest did to have any chance of enforcing the ban.

1. Most patients can not afford to grow.   Indoor sets up cost a minimum of $1500.00 and then the monthly fees in electricity, nutrients and maintenance are $200-$400.

2. Growing outdoors is difficult.   It is not as simple as planting a seed and giving it water once per day.   Outdoor grows deal with significant infestations which can destroy a plant very easily.  Also, patients will have to hand water and wash the plants daily.

3. Not everyone has a yard to grow.   In addition, some patients  that have yards have neighbors that will not appreciate the odor of 12 marijuana plants wafting into their yards.

4.  Some patients have teenagers or small kids and it is not practical to grow.  I recently spoke to a 46 year old patient who has the money and yard to grow, but has 5 kids ages 4-14 in his house and their is no way for him to grow in that environment.  He wants to keep his use private.

5.  Patients don’t have the time to grow.  It takes minimum 90 days to yield medicine once you start growing.   What does the patient do who was diagnosed with cancer and is starting chemotherapy tomorrow?   I see these patients all the time.   They need safe access to medicine right now and are not going to wait 90 days for the plants to potentially be ready.

6. What strains do they grow?  Not all cannabis is the same and each patient requires a different strain depending on their symptoms.   Some patients do great with indices and some better with sativas.  Some patients do best with a hybrid strain.   There is no way to tell what strain they are going to do well with until they try it.   This is why having a dispensary that is local is so important.   Patients can walk in and purchase 3 or 4 different strains to narrow down which ones will work.

I am sure there are many other reasons in addition to the ones I just listed which make it impractical for patients to grow their own medicine.     People who set policy need to consult with experts who understand the process before they outright ban all medical marijuana dispensaries.

Multiple sclerosis is a chronic progressive disease that affects the myelin stealth thats wraps around the nerve.  Think of the myelin as the the black rubber portion of an electric cord that protects the wiring within.   Patients have terrible muscle spasms and pain associated with this disease and not many medications are effective at treating it.

What patients report to me is that there muscles spasms are reduced to the point that they can sleep throughout the night and also do not need to take (or take less of) the prescriptions their neurologists prescribe.  I consider this very successful.   Obviously not curative but there IS no cure for MS yet.

If you know someone who suffers from this disease I encourage you to refer them to a doctor who is familiar with using cannabis to treat these patients.

A Los Alamitos doctor, who was punished last year after a plastic
surgery patient died, is facing more California Medical Board
discipline stemming from his work at a beach-front medical marijuana
clinic in Venice.

In the latest medical board case, Dr. Lawrence H. Hansen is accused of
dishonest or corrupt acts for practicing medicine in a clinic owned by
non-doctors, a violation of state law.

While California allows seriously ill patients to obtain medical
marijuana recommendations from their doctors, solicitors for Kush
Doctor in Venice stood outside with fliers inviting passersby to come
in for a recommendation, according to accounts from undercover medical
board officers.

In April of 2011, the medical board and law enforcement agencies
raided the Kush clinics, seizing large bags of marijuana. Last year,
the Los Angeles County district attorney’s office filed felony
criminal charges against two clinic operators for allegedly possessing
and distributing marijuana for sale and for practicing medicine
without a license, according to Superior Court records.

Hansen was reached Monday at a different Kush clinic in West Los
Angeles and said he was unaware of the latest medical board accusation
against him.

“I haven’t done anything wrong,” Hansen said. “I’ll have to check into
it.”

Legal documents recently made public by the medical board give this
account:

In January 2010, the board was alerted that non-doctors were operating
Kush Doctor, a collection of medical marijuana clinics along Ocean
Front Walk in Venice. State law says only licensed physicians can own
and operate medical clinics.

In June 2010, an undercover medical board officer visited two Kush
clinics. The officer met Hansen, who said he had worked there for the
past 18 months. The officer told Hansen it was unethical to provide a
medical marijuana recommendation without a proper physical exam.

In August 2010, the board sent two undercover officers to pose as
patients. An officer was asked if he wanted to get “legalized” to use
marijuana for $150. The officer said the price was too much and agreed
to pay $70. The officer said he was seeking marijuana for relief from
headaches resulting from heavy drinking and inability to sleep.

He saw an unidentified doctor who briefly examined him before he was
given a medical marijuana recommendation card. Hansen is not mentioned
in the description of the August visit.

At another Kush clinic, the officer asked another unidentified doctor
where he could buy marijuana after receiving the recommendation. The
doctor told him it was illegal to give information and then whispered
“next door, upstairs.” The officer then went to the upstairs
dispensary and bought $20 worth of marijuana.

In February 2011, Hansen was put on 35 months of medical board
probation and barred from performing surgeries after the death of a
patient he operated on. (http://www.ocregister.com/articles/surgery-288471-board-documents.html
)

Hansen had retired from active practice in 2003 but in 2008 performed
a vaginal reconstruction at an unaccredited outpatient surgery center
in Anaheim Hills.

The medical board documents say Hansen met the patient, Maria Garcia,
for the first time shortly before the surgery and failed to take a
thorough medical history or perform a comprehensive exam. During the
surgery, Garcia, 39, began to bleed. Afterward, she underwent
liposuction, which was performed by a different doctor.

Garcia suffered a heart attack and died an hour later at a hospital.
Hansen was accused of incompetency for failing to verify that the
surgery center was accredited or check on his patient at the hospital
after he learned of her complications.

To check a doctor’s disciplinary record visit mbc.ca.gov/

Contact the writer: Twitter: @cperkes 714-796-3686 or cperkes@ocregister.com

http://www.ocregister.com/articles/medical-348615-board-marijuana.html

My first patient was a 94 year old women who has end stage pancreatic cancer.   Her son said that she has no appetite and is nauseated constantly.   Her weight is down to 89 pounds and she has been throwing up the majority of the nutrition she tries to eat.   In this case, I advised my patient to vaporize as much as possible to reduce the nausea and stimulate her appetite.   She ended up using an indica strain which worked “tremendously” per her son.

My second patient was a 77 year old women who has breast cancer with metastases to her brain.  While in my office she threw up three times secondary to the tumor in her brain.   Like my first patient she is having a difficult time eating and has lost 30 pounds in the past 2 months.

I receive emails from hundreds of families across the country who have family members in situations just like this who do not have access to medical marijuana.   The stories are all similar.  They just want some relief from the suffering associated with advanced disease and end-stage illness.

In my experience medical marijuana has worked excellent for relieving nausea, reducing pain, increasing appetite and improving sleep.   Most patients in home hospice suffer from one of these symptoms and can benefit.   Unfortunately only 16 states approve the use of medical marijuana.   In California, patients can easily purchase medicine from local collectives and choose from over 20 strains.   Many dispensaries have edibles in the form of sodas, teas, chocolate, lolly pops, cookies, brownies and even ice cream.    I have also had hospice patients use tinctures sublingually and also take cannabis in pill form.  The great thing is that patients can also vaporize the medicine which is smoke free and odorless.

If you have questions about end of life care and medical marijuana feel free to contact my office. We are located in Irvine and Long Beach, CA.

Here are some common questions I get from patients?

1. How can I legally grow 99 plants?

The answer is that you can’t in the state in California unless you can prove that you medically need that much cannabis to treat your condition.   Many patients argue that because they make edibles they need this number of plants to produce enough medicine.   What will happen is that the prosecutor will place the burden of proof on the patient to prove they use this much medicine.   They will argue to the court that 99 plants will produce over 100 pounds of medication every 90 days which is virtually impossible for any one patient to use.

2 What if my doctor gives me a plant exemption to grow more than 12 plants?

I have seen doctors sell “Growers Certificates” for $250 which authorizes the patient to grow up to 99 plants.  The problem is that a “Growers Certificate” from a doctor will NEVER hold up in court for a few reasons.

a. There is no FDA recommended dose established therefore there is no way for a doctor to determine how much medicine a patient will need.

b. There is no training that doctors receive which gives them the credentials to know how much medicine a patient will need.

I have testified in court on more than one occasion for patients who were arrested for plant numbers.  In both cases it was clear they were going to lose and both had to take a plea bargain.   They could have one but it was costing them in the $75,000 range to find out.

3. Can I grow 12 plants and sell my cannabis to a local dispensary?

If you are a member of that collective and also have a growers agreement with them (ask Mr Curiale about this) you are legally allowed to do this.   The members of a collective are supposed to get their medicine from within the collective.

4. Can I travel out of state with my cannabis?

The short answer is that prop 215 only applies to California and you are not able to legally transport cannabis to other states.

5. Can I fly with medicine if I am traveling within California?

The answer is that the airlines have their own rules and you have to check with your airline prior to flying.

6. Can I legally use cannabis if I am under 21?

The answer is that a doctor can recommend cannabis to a patient of ANY age.   However, most doctors, including myself, are not recommending cannabis to patients under 21 because of federal guidelines that treat cannabis as a schedule 1 drug.   You may have to call around to find a doctor willing to recommend it to you.    For the record, the percentage of patients who are under 21 seeking medical marijuana recommendations that are MALINGERING (lying) is VERY high.

7. What is a primary caregiver?

Someone who is a designated primary caregiver for another patient is allowed to purchase, transport, possess and grow marijuana for that patient.  They can not however use the medication personally.   To be a primary caregiver you have to someone who regularly provides services for that person.  For example,  you must house, feed or regularly assist them with daily tasks outside of just getting them their medical marijuana.

Here is the email I received from her today.  It is truly amazing how cannabis can be a “Godsend” for some patients.

Hi Dr. Breen,

I met you yesterday. I have Cervical Dystonia and I am currently battling Botulism because I contracted it from my last treatment of Botox for the Dystonia. I tried the Medical Cannabis for the first time last night and I want to thank you. It is the first time in YEARS that I have slept a full nights sleep. I am crying as I write this to you. I can’t thank you enough. My husband and I were so scared to try this for me because he is in law enforcement and I used to be and we are also both Christians. I thank God that he lead us to you. I know that God did and I thank you for what you do.

From the bottom of my heart THANK YOU!!
LOVE,
XXXXXXXXX

I went on to explain to her that I have treated hundreds of patients going through chemotherapy and that I expected her to do very well.    She can expect: 1. Less pain 2. Less nausea 3. better sleep 4. Improved appetite and hopefully 5. An improved mood.

Most patients will stop their narcotics all together.   They also stop taking any sleeping pills or antiemetics (anti-nasuea pills).   Most oncologists acknowledge the benefits of using medical marijuana but few are willing to recommend it to their patients.   This patients oncologist was compassionate enough to give her a direct referral to my clinics.

I expect that she will do well.   There is a great dispensary in Long Beach called Herbal Solutions that will take the time to find a strain that works best for her.  Even though she is 77 years old I anticipate that she will be able to use the vaporizer without difficulty.

Lastly, all of our prayers are with her and her husband as they go through this difficult time.   Expect a miracle!!