Author: Michael Morgenstern, MD

Medical Cannabinoids for Chronic Pain

On December 1st, 2016, the New York State Department of Health announced that chronic pain: “will be added as a qualifying condition” for medical cannabinoids. This major development would enable us to treat chronic pain with medical cannabinoids. Prior to this, patients would need to have another qualifying condition, like neuropathy or cancer, in addition to a symptom of chronic or severe pain, to obtain medical cannabinoids. Since most patients with chronic pain do not have one of these conditions diagnosed, the news is significant. Nearly 40% of Americans have chronic pain, compared to around 2% who have a diagnosis of neuropathy. At the...

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Medical Cannabinoids for Neuropathy

Medical Cannabinoids for Neuropathy Neuropathy qualifies for medical cannabinoids in New York, however the conditions that qualify as neuropathy are less certain. In general, neuropathy means a nerve disorder but the law doesn’t explain what “Neuropathy” means and the medical definition isn’t always clear either. There are different types of neuropathy and different verbiage is used to describe neuropathy. One may refer to a nerve disorder in the wrist as Carpal Tunnel Syndrome or as a “distal median neuropathy.” In a neurology text, Guillain–Barré syndrome may be referred to as a lumbosacral polyradiculoneuropathy, or polyneuropathy. So, if you ask two doctors “What is neuropathy?” you can expect to get completely different answers. This lack of clarity also extends to what conditions are considered to be neuropathy. Is a disorder of the nerve roots deemed Neuropathy, Radiculopathy or both? While the definitions rarely affect the management of a disease, they are nonetheless important for facilitating access to medical cannabinoids treatment in New York – important for those who need it to alleviate disabling pain and important for the providers who want to comply with the law. Basic Anatomy of the Nervous System The nervous system has millions of neurons or nerve cells. The Central Nervous System includes the brain and spinal cord and is made up of central nerves. The peripheral nervous system has nerves that extend outside of the spinal...

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5 Ways to Find a New York Medical Cannabinoid Doctor

Finding the right doctor in New York to treat you with medical cannabinoids is not always simple. But it isn’t much different than finding any other specialist. First find a doctor that treats patients with medical cannabinoids nearby. Next, find a doctor that is specialized and experienced in treating your condition. Finally, find a doctor who has satisfied patients. 5 steps to find a medical cannabinoids doctor in New York that’s right for you 1. Ask your doctor to recommend a medical cannabinoids provider A good place to start is with your primary care physician or the physician treating your specific condition. If your doctor doesn’t treat patients with medical cannabinoids, can he or she recommend someone else? Ask if your doctor can recommend two specialists, and, also ask why one would be recommended over the other. Is the recommendation based on reputation, convenience, or some other factor? You may also want to ask what other patients have said about that doctor. Since medical cannabinoids treatment in New York is relatively new, don’t be surprised if your doctor doesn’t have enough information, is not able to offer a referral, or is not able to answer all your questions. If that’s the case, the internet is another great resource for finding medical cannabinoids doctors in New York. 2. Search online for New York medical cannabinoids Doctors Most online resources have...

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Medical Cannabinoid Kills Cancer in a 14 Year Old

In March 2006, P.K., a 14-year-old girl from Toronto who we will call Phoebe, developed bruising and shortness of breath. Upon going to a Toronto hospital, doctors determined that she had an aggressive form of cancer called acute lymphoblastic leukemia, also known as ALL. At the time of diagnosis, she had over 300,000 blast cells,* abnormal blood cells that interfere with normal cell function. Transplant and Chemotherapy to Kill Cancer Phoebe began chemotherapy shortly after her diagnosis. In August 2006, when it was evident that the standard chemotherapy had failed, Phoebe received a bone marrow transplant. The transplant process, which kills off all remaining white blood cells before replacing them with transplant cells, leaves the body vulnerable to infection. Phoebe was isolated for 45 days after the transplant. At a follow-up appointment in February 2007, doctors observed more blast cells in her blood, indicating that the transplant had been unsuccessful. Phoebe was then treated with a more aggressive chemotherapy regimen, but after nine months, her cancer was still not responding. More treatments followed, but doctors were running out options. In July 2008, Phoebe, now 16, was rushed to the hospital with a severe headache. A number of tests, including a CT scan of her head, indicated that blast cells had metastasized to her brain. On February 4, 2009, Phoebe experienced internal bleeding, and blood tests showed a growing number...

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Doctors against Medical Cannabinoids

Some doctors oppose medical cannabinoidsPatients may be surprised to learn that some doctors are against medical cannabinoids. While the majority of doctors would recommend it under certain circumstances, both here in New York and across the country, there are opponents who argue that it should not be prescribed under any circumstances. Physicians’ opinions about medical cannabinoidsIn 2013, the New England Journal of Medicine conducted a global opinion survey to ascertain physicians’ attitudes towards prescribing medical cannabinoids. According to the survey, the main reasons doctors are opposed to prescribing it are: inadequate supporting scientific evidence, lack of provenance, inconsistent dosages and concerns about medical cannabinoids's side effects. In contrast, proponents advocating for medical cannabinoids treatment focused on patient choice, the lack of safe alternatives and their strong desire to alleviate their patients’ pain and suffering. medical cannabinoids lacks evidenceMedical doctors are trained to treat based on scientific evidence. They rely heavily on the outcomes of well-designed clinical trials, as well as the scientific method. The best evidence is level I, which requires large, randomized, double-blind placebo controlled trials with clear cut results. Level II evidence may not be as strong and can be from smaller trials where the results are not as clear, or lack a placebo group in a randomized trial. However, these levels of evidence are often absent for all of a drugs indications. Many drugs are found to have...

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