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AD 2016 Q3

Alert Diver is the dive industry’s leading publication. Featuring DAN’s core content of dive safety, research, education and medical information, each issue is a must-read reference, archived and shared by passionate scuba enthusiasts. In addition, Alert Diver showcases fascinating dive destinations and marine environmental topics through images from the world’s greatest underwater photographers and stories from the most experienced and eloquent dive journalists in the business.

RESEARCH, EDUCATION &

RESEARCH, EDUCATION & MEDICINE EXPERT OPINIONS unexso @unexsobahamas performance, is likely to exacerbate nitrogen narcosis. The effects of marijuana on divers need to be investigated before any definite statements can be made regarding safety. In the meantime, extreme caution is recommended. Neuman: There are no data that currently exist to suggest whether or not the use of marijuana would exacerbate or possibly ameliorate the effects of nitrogen narcosis. We do know that alcohol and marijuana act additively, and thus it would not be a surprise if the effects of marijuana exacerbated the effects of nitrogen narcosis. In a laboratory setting it would be relatively simple to examine this question, however, validating the results of laboratory testing in an actual diving environment would require separate testing. The first step in further evaluating this question might be conducting chamber dives to depths at which we already know nitrogen narcosis produces measurable effects. How long after using marijuana should someone wait before diving? Gillon: Like alcohol, marijuana should be undetectable in a person’s system before he dives. STEPHEN FRINK Although some divers who use marijuana might believe that diving must be safe as long they wait a day or two (or less) after smoking, these divers may be envisioning calm, clear, shallow water. If they were to consider the possibility of managing an unexpected current, poor visibility or a sudden emergency, they might be more concerned about the potential for lingering performance decrements. 50 | SUMMER 2016

When marijuana is inhaled at sea level, the THC metabolites have an elimination half-life of at least 20 hours and possibly up to three days. Some are stored in body fat, however, and have an elimination half-life of 10 to 13 days. Most researchers agree that urine tests for marijuana can detect the presence of the drug in the body for up to 13 days. But for some individuals it may remain even longer. There is anecdotal evidence that the length of time that marijuana remains in the body is affected by how often the person smokes, how much he smokes and how long he has been smoking. Regular smokers have reported positive drug test results after 45 days since last use, and heavy smokers have reported positive tests up to 15 weeks. So MEET THE EXPERTS Paul S. Auerbach, M.D., MS, FACEP, FAWM, FAAEM, is the Redlich Family Professor of Emergency Medicine at Stanford University School of Medicine and medical director of Strategic Projects at Stanford Health Care. He is the world’s leading authority on wilderness medicine and one of the world’s leading authorities on emergency medicine. He has received numerous science and diving awards. Ernest S. Campbell, M.D., FACS, a retired surgeon, is a Fellow of the American College of Surgeons and a member of the American College of Physician Executives, among other affiliations. At Brookwood Medical Center in Birmingham, Ala., he served as chairman of the surgery department and president of the medical staff. He is a PADI Rescue Diver and has a U.S. Coast Guard captain’s license. Steven D. Gillon, DO, is a gastroenterologist and owner of the Digestive Health Center of Englewood in Englewood, N.J. He has been practicing gastroenterology and internal medicine for 30 years, and he prescribes marijuana for selected medical cases that meet the legal requirements. Richard E. Moon, M.D., CM, M.Sc., FRCP(C), FACP, FCCP is a professor of anesthesiology and medicine at Duke University in Durham, N.C. He is also the medical director for the Duke Center for Hyperbaric Medicine and Environmental Physiology. A world-renowned researcher in anesthesiology, pulmonary, undersea, environmental and hyperbaric medicine, he has authored more than 100 peer-reviewed publications. Tom S. Neuman, M.D., FACP, FACPM, an emergency medicine physician and pulmonologist in La Jolla, Calif., is well known for his work in diving and hyperbaric medicine. He has published numerous books and scientific papers on diving physiology and is the co-editor of the Physiology and Medicine of Diving. Neuman is a recipient of the DAN/Rolex Diver of the Year Award for his contributions to dive safety. DAN-UHMS Diving and Hyperbaric Medicine Course September 24 – October 1, 2016 Anse Chastanet, St. Lucia Developed for physicians but open to other healthcare providers and individuals interested in diving medicine, this program provides up to 24 hours of continuing medical education credit for physicians. Topics include: • Medical and physical fi tness to dive • Diving safety issues and current research • Decompression physiology and pathophysiology • Diving injuries and management • Science and use of hyperbaric medicine • Includes all meals, beverages and transfers • Free Nitrox • Tech diving available • Nine spacious suites Exclusive lodging/meals/diving package has been assembled for course participants. For more information, visit DAN.org/cme or write to dan.uhms.cme@dan.org ALERTDIVER.COM | 51

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