1)Medical marijuana dispensaries in Long Beach, CA are not going anywhere yet.   At a recent meeting with the city counsel they decided to delay making any decisions until the State Supreme Court decides whether or not to hear the case next month.   If they decide to take the case it will be at least a year before the city can do anything.  In the meantime patients will continue to have safe access to quality medicine.  

2) The DEA and Orange County sheriffs department raided three dispensaries in Costa Mesa on Tuesday however made NO arrests.     The city continues to struggle with dispensaries operating in their city and refuse to write a sensible ordinance to allow for safe access to medicine for patients.   Otherside Farms and 2 others closed shop after the Feds took all of their medicine, cash and records.

3) The mayor of Costa Mesa was on a local medical marijuana radio show, hosted by Robert Martinez of Newport Mesa Patients Association, stating that he supports the city writing an ordinance that allows them to operate legally.  Word is that they are trying to get a special election for this summer so the people can decide for themselves if they want it in the city.

4) Two medical marijuana patients made the news this week.   Both were arrested and charged with selling marijuana to non-patients.   One male was stopped while driving after purchasing 7 ounces of marijuana from one dispensary.   When they looked at his phone they found text messages from various people asking where they could meet him to buy marijuana.   The second was a female who was selling marijuana to non-patients at a local high school.   Unfortunately for her two of the people she sold marijuana to were undercover police officers.

**for the record. Dispensaries that sell more than a few ounces to a patient at any given time should be shut down.  It is obvious that these “patients” are buying that quantity of medicine so they can sell it on the black market.  There are RARE exceptions of course**

Here is what I anticipate in 2012:

1. More uncertainty:   More cities will try and create ordinances to limit where dispensaries can operate.    It also looks like Katherine Harris is going to release a new set of guidelines to qualify how the system needs to work.   Word on the street is that California wants to get away from ALL storefront dispensaries. The question is going to be how do patients get safe access to medicine.

2. Patients will still be able to get recommendations from their doctors and grow 12 plants at home at will.   There WILL be dispensary locations to get their medicine but they may have to drive a little bit further than last year.

3. Delivery services will start thriving.    We are already starting to see many delivery services taking over in areas where dispensaries closed.   This is a good thing as it limits the visibility of medical marijuana and hopefully the cities will forget about it and leave them/us alone.

4. Ballot initiative: it looks like proponents of total legalization for recreational use are going to put another ballot measure for vote in November.  I expect this to NOT pass by about 3-4% points just like proposition 19 failed.    However I expect a second ballot initiative to be placed on the books to tax and regulate MEDICAL marijuana.   This I think WILL pass but ONLY IF they do a great job at promoting it as MEDICAL and not recreational.   So how they campaign will be huge.

5. Doctors: expect a handful of doctors to lose their licenses this year for failing to follow the medical board guidelines.   I expect that we will see a lot of these fly-by-night clinics closing and falling like dominos once the medical board takes action.  This is a good thing.

6. Expect President Obama to LOSE CALIFORNIA in the general election.  This will mean the end to his presidency.   The one vote that he had was the left that thought he was a proponent of medical marijuana.  He HAS LOST that vote 100%   Across the board people are fed up with his lip service on respecting states rights.  Expect the next Republican President to be neutral on this issue.   I believe a republican president will be more inclined to respect states rights.

I expect Governor Brown to create a sensible plan for medical marijuana in California.  He is a thinker and a realist.    He will understand the futility of pushing medical marijuana back to the black market.

Stay tuned!

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.

What are the ramifications of drinking 62 grams of sugar in the morning (or ever for that matter?)   The body was not designed to handle that much sugar at any one time.    Because it is in the form of sucrose it gets rapidly absorbed which causes a spike in the amount of insulin in the blood.    Insulin is a fat storing hormone produced by the pancreas.  One of its main goals is to make sure that the brain, kidneys, heart and other vital organs have enough sugar (glucose) to maintain normal function.    If there is any sugar left over insulin tells the body to store it as fat.    That is why eating sugary foods and drinks (even if they are fat free) makes you fat.   It is the conversion of sugars to fat which takes place in the liver that makes these drinks so harmful to your health.

High insulin levels lead to diabetes, cancer, high blood pressure, depression, decreased libido and inflammation.   Across the board it is THE WORST thing that patients do to their bodies on a daily basis.

I always find it amazing when I am in starbucks and I here the staff call out “Steve. Non-Fat Venti Vanilla Frappuccino”   It is the non-fat part that makes no sense at all.    The amount of sugar that is in that drink is the equivalent of eating 32 vanilla wafer cookies!   Thirty-two!!!

One in three people born in the US in the year 2000 will go on to have diabetes.    Diabetes will be the leading cause of death by the year 2020.   It is already the leading cause of blindness, kidney disease and cardiovascular disease.

Most patients, if they just drank water and cut out the empty calories in sugary drinks would lose weight.  Their blood sugars, cholesterol and blood pressure would also improve.

TIP OF THE DAY: look at how many grams of sugar you are drinking every day.    Most people are getting their entire daily carbohydrate requirement in two drinks before they ever take one bite of food.

These closures are not unexpected.  The medical marijuana industry went from being very profitable, to maybe cover the overhead and take a small salary, to being not profitable at all in a 3 year period.     Why the rapid change?   The simplest explanation is because the playing field was not level and the market priced good clinics out.  Let me elaborate.

Marijuana is considered a controlled narcotic drug by the california medical board and they expect it to be prescribed like any other controlled narcotic.   This means a doctor (MD/DO) has to evaluate the patient, order an necessary tests and prescribe it under the same standard of care as if they were prescribing vicodin.   Clinics like medicann employed professional doctors who followed the rules as set by the medical board.   These doctors were paid $80-$100/hour to issue recommendations.   The overhead to run a clinic was fairly substantial.

ALONG CAME POLLY

What happened fairly quickly is that dispensary owners and entrepreneurs realized that if they put a doctors office next to their dispensary it would serve as an endless source of leads for their dispensary.    These people could care less if the clinic made money as they knew that if they just broke even they would make a fortune in selling marijuana to those patients.    What they did was undercut the going cost of a recommendation ($150 at the time) by 75% and started offering recommendations for $25.00.    Some clinics even had doctors their via skype to limit the cost of having a doctor on location.   Under normal business circumstances, supply and demand dictate where the market is at and the price settles accordingly.

But these weren’t normal business circumstances.   These new clinics that were undercutting the price of legitimate clinics were running illegal operations.   They did not have doctors present (required by the medical board) and more importantly the offices were not owned by doctors.   This is considered an illegal medical practice and is a felony in California.    Only doctors can have ownership in a medical practice.   Secondly, they handed out recommendations to anyone who could fog a mirror.  They didn’t require medical documentation supporting their diagnosis nor examine their patients.    It wasn’t long before these clinics were 30-50 patients deep with lines extending out their doors.

With the economy slumping and unemployment at an all time high, patients that would normally go to medicann and get a legitimate recommendation were lured by the price of a cheap recommendation.   This severely hurt the business of every doctor who ran a legitimate practice.   Ultimately many had to close.

The future:   Just as the mortgage industry went from normal, to insane and now back to being overly cautious to the point of being ridiculous, the same thing is happening in the medical marijuana industry.    The medical board is slowly weeding out doctors who are not following the standard of care and cities are closing dispensaries run by criminals who also operate illegal medical clinics.    Ultimately the situation will return (close) to what it was in 2007.   You will have a handful of good doctors willing to recommend medical marijuana for a legitimate price.

In this patient he was actually on a 27 hour sleep cycle.    This means that there are times where 1 in the afternoon feels like 1 in the morning.   Obviously it was very disruptive to his daily life and makes it very difficult for him to function at work with massive amounts of caffeine during the day and heavily sedating drugs at night.

Unfortunately caffeine has a ton of bad consequense and this patient was becoming addicted to sleeping pills.   Specifically, he was using more and more temazepam which is a benzodiazepine medication (like valium).   He came to me in search of a potential alternative.

His sleep specialist told him that he may benefit from a trial of medical marijuana.  There is more research coming out that says that indica strains that are higher in cannabinol (CBD) and lower in tertahydrocannabinol (THC) are more sedating than traditional sativa based marijuana strains.   They tend to be less psychoactive and more sedating.  Therefore patients do not get the intense head high but instead a “body relaxation” effect.

Although I have yet to see any major studies that have compared different strains of medical marijuana I do not that patients report different effects when they use indica versus sativa strains.    Much more research has to be done in order to get an answer that will undergo the rigors of scientific scrutiny but until the federal governement re-schedules marijuana it will most likely NOT happen in the United States.

Stay tuned and continue to petition your politicians to put pressure on the government to allow the safe and funded research of medical marijuana.

I am going to give you some basic guidelines to help you make the right decision.

1. Call the clinic first and ask them the following questions:

a.  Is the doctor going to physically be present or will I be speaking to a doctor over skype (computer) or phone?   The medical board of California states that to have a legal recommendation the initial consultation MUST be done in person, face to face.   There have been a plethora of clinics that are doing recommendations over skype for dirt cheap.  SAVE YOUR MONEY.  Local dispensaries know who these clinics/doctors are and do not accept their recommendations.   So essentially you just wasted your money and more importantly time.

b. Ask them for your fictitious name permit number?    Any clinics that advertises a name other than the doctors name requires this by law.    In order to obtain one they have to prove that the clinic ownership is a doctor.   In California, only a doctor can own a medical practice.   However what has happened is many dispensary owners and entrepreneurs have opened clinics with hopes of getting rich and just hire doctors to see patients.   This is ILLEGAL and considered a felony (look up “the corporate practice of medicine” and “aiding and abetting an illegal medical practice”)    Clinics that are NOT owned by doctors will not have a fictitious name permit.

c. Ask them if you can still get a recommendation if you do not have medical records with you?    By law, in order for a doctor to recommend medical marijuana, they must first verify that you have an accurate diagnosis.   Many of these clinics you can just walk in and say you have headaches and they will issue you a recommendation.   These clinics will come and go (they eventually get caught) and your recommendation is not valid.

d. Ask them where the nearest dispensary is?   If they tell you it is right next door than run for the hills screaming.  This is the obvious sign that the medical clinic is being run by the dispensary and is most likely an illegal medical practice.

e.  Ask them for the doctors name and medical license number?   You want to see a doctor whose license is in good standing with the medical board.   Many doctors who are issuing medical marijuana recommendations have suspended licenses and are just trying to make as much money until they ultimately lose their license.   You can go to the medical boards website and search for free.

2.  Call a few local dispensaries and ask them if they can recommend a reputable doctor in your area.   Most of the dispensaries know where the good clinics are and can give you non-biased feedback.

I hope that helps!

LASTLY, IF YOU ARE IN THE ORANGE COUNTY OR LONG BEACH AREA YOU CAN CERTAINLY MAKE AN APPOINTMENT TO SEE DR BREEN.   SIMPLY GIVE US A CALL AT 877-721-0047

1. Are you 18 years of age? Most doctors will not recommend medical marijuana to minors even with parental consent and a qualifying diagnosis out of fear of losing their medical license.    Therefore, with some exceptions, you need to be at least 18 years of age to obtain a medical marijuana card.   Also, most dispensaries only help patients 21 years and older.    Legally however you can obtain a medical marijuana card at any age with parental consent.

2. Are you a California resident? You must have a valid California drivers license or state issued ID to qualify in California.   This means out of state residents who are visiting do not qualify.

3. Are you on probation or parole? The law states that patients on parole or probation can not receive a medical marijuana card unless they have official approval in writing from their parole officer.   Convicted felons can not qualify.

4. Do you have a qualifying diagnosis? In California there is a list of diagnosis that qualify automatically.  HOWEVER, in addition doctors can recommend medical marijuana for anything that it provides relief for and that evidence can be backed by patient reports.   Therefore if you have chronic insomnia (for example) and can not tolerate ambien or lunesta and have used marijuana with good results, you would qualify.   Any of these conditions have to interfere with your normal activies or bodily functions as per the American Disability Act of 1990.  This would mean it would be a serious medical conditions.

Before you read the list below, patients with any diagnosis where pain has persisted for more than 3 months (definition of chronic pain) DO qualify.   The other more common things you can get a medical marijuana card are for insomnia, anxiety, back pain, nausea, muscle spasms, headaches, PMS, menopause, arthritis, lack of appetite etc.

“Serious medical condition” means all of the following medical conditions:

1. Acquired immune deficiency syndrome (AIDS);
2. Anorexia;
3. Arthritis;
4. Cachexia;
5. Cancer;
6. Chronic pain;
7. Glaucoma;
8. Migraine;
9. Persistent muscle spasms, including, but not limited to, spasms associated with multiple sclerosis;
10. Seizures, including, but not limited to, seizures associated with epilepsy;
11. Severe nausea;
12. Any other chronic or persistent medical symptom that either:
    1. Substantially limits the ability of the person to conduct one or more major life activities as defined in the Americans with Disabilities Act of 1990 (Public Law 101-336); and
    2. If not alleviated, may cause serious harm to the patient’s safety or physical or mental health

5. Do you have medical documentation verifying your diagnosis? It is not enough to walk into the doctors office and tell them you have headaches for example.   You need to have some medical documentation that another physician evaluated you for the condition that you are complaining of.    So if you have back pain, you would probably have an x-ray or MRI report.   Or you may have physical therapy notes etc.    As long as you can document that you have been formally diagnosed you can qualify.

6.  Once you have a documented diagnosis you can then talk to a doctor that is willing to recommend medical marijuana.  In California there a many clinics that specialize in this because patients primary care doctors or specialist are NOT WILLING to recommend it.

7.  Once you make an appointment and bring your medical records you will then see the doctor.   This doctors appointment SHOULD be like any other doctors visit.  For example, in my office, you will fill out a patient medical history form, have your vital signs taken (blood pressure, temperature, pulse) and I will review everything with you.  I will perform a physical exam and then go over all the benefits and risks of using medical marijuana (called informed consent).  I then show you how to use a vaporizer so you don’t have to smoke it and lastly my staff will go over how to find a reputable dispensary.

That is it!  It is not as difficult as you may thing and certainly should not be intimidating.

If you are located in Orange County or Long Beach feel free to call our office at 766-721-0047 or pre-qualify for FREE on our website at www.MCSoCal.com

** Photo of Dr Breen with an Iraqi Imam as they turn over their care and trust to the Americans**

Ali lost his Mother, Father, brother and 13 of his relatives when a stray American bomb struck his house.   Ali lost both his arms and had 3rd degree burns over the rest of his body.    60 minutes featured a story about Ali in 2007 and Dr Breen can be seen transporting him from an Iraqi hospital to awaiting  US Marine humvee ambulances at the 3:40-3:47 time mark of the interview.  He is dressed in camouflage with one of his Navy Corpsman trailing behind.

Below is the link to the story on 60 minutes:  it is inspirational and shows the human side of two waring countries.  Dr. Breen recalls as he was transporting Ali out of the hospital that he was being screamed at by hospital workers “you did this to him!” .   “It was a very intense situation” Dr Breen recalls.   “Outside the hospital there were thousands of people chanting God is great in Arabic and they were also parading another deceased Iraqi teenager through the streets.  I was just trying to let the local Iman know that despite the fact that our countries were at war, I am a fellow human being and would take care of Ali as if he were my son.  I do recall wanting to get the heck out of there as the crowds began to get pretty upset.  I remember them putting a camera in front of my face and waiting for me to say something to the world.    Not sure what to say I uttered the following: We agree to take Ali into our care and also into our hearts.”  Those words seemed to melt away any animosity and in the picture the Imam grabs Dr. Breen’s hands and thanks him.

From Dr. Breen: Often I think of that day and about Ali laying in bed scared to death of me.    I could not imagine how much courage it took for him to leave that hospital and get into a US Marine ambulance flanked by M19 grenade launchers.   I often think of how lucky we are as Americans to live in such a stable country with access to the best health care in the world.   It is only when we see how children in other countries that we truly appreciate what we have here.    One day I would like to meet with Ali and see him as an adult thriving in society.   I am honored that I took a small role in helping him back to safety and health.

http://www.cbsnews.com/video/watch/?id=2796107n&tag=mncol;lst;1

While many medical marijuana clinics have come and go over the past 4 years, our doctor has been the only physician who has been consistently taking care of patients during this time.    His recommendations are respected and honored at every medical marijuana dispensary in the Long Beach community.    The reason for this is that our doctor adheres to the strict guidelines that the state medical board set up to qualify patients to use medical marijuana.

1. Every patients recieves a thorough review of their medical history.

2. Every patient receives a complete physical exam.

3. Every patient reads and signs an informed consent which is required by law.

4. Dr. Breen personally follows up with each of his patients and monitors their progress on an ongoing basis.  All follow up visits within the first 12 months are free of charge.

5. Our office follows all HIPAA (patient privacy) guidelines.

In short, our doctor treats his patients in a professional manner similar to any other family medicine doctor.   His patients are well informed, well taken care of and have complete legal immunity in the event any legal issues arise.

To make an appointment please give our professional staff a call at 877-721-0047 or visit our website at www.mcsocal.com