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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 without human trials specific to marijuana use and diving, we can only guess at safety parameters, and they would have to be extremely conservative. Is there currently any way to establish a correlation between the use of marijuana and diving accidents? Neuman: If one were to use the data from motorvehicle accidents as a surrogate for dive accidents, the results are not as clear-cut as the laboratory evidence might suggest. Adverse effects of marijuana have not been conclusively demonstrated in experiments involving simulated driving. Furthermore, in epidemiologic studies of motor-vehicle accidents, marijuana has not been shown to be a major problem. Unfortunately, all of the existing studies have major methodologic problems (i.e., are flawed). [Author’s note: Research funded by drug companies may be influenced by the potential profits associated with getting drugs to market as quickly as possible. Maida Taylor, M.D., MPH, who has worked in drug development, notes, “There is a problem in the research that has been done on marijuana by the pharmaceutical companies, even in the most controlled circumstances, because of the strong sociopolitical agenda.”] Perhaps most important, no way currently exists to determine (with laboratory testing) whether an individual is under the influence of marijuana or has merely been exposed to it sometime in the past hours to days. This problem is related to the way marijuana is metabolized and eliminated from the body; it is not merely a technical issue of detection. Furthermore, the active agent in marijuana is usually not detectable in the bloodstream after two hours from the time of inhalation. Thus, by the time a person arrives at a hyperbaric chamber the likelihood that useful information could be obtained by any currently available blood test is extremely small. Assuming this technical problem is resolved, there are still extremely large problems that will need to be overcome before any causative relationships between marijuana use and dive accidents can be established. The single greatest issue will be the ability to find an adequate control group for comparison. Given oceanviews Enter the photo contest sponsored by DAN ® and Nature’s Best Photography. open oct. 10 to dec. 12, 2016 © SCOTT PORTELLI Get the details and enter online: naturesbestphotography.com/oceanviews 52 | SUMMER 2016

the relatively small number of diving accidents, the difficulty in establishing a meaningful control group and the technical difficulties in establishing a relationship between laboratory testing and impaired performance in a real-life setting, it may be quite some time before we can clearly delineate the role of marijuana in diving accidents. Until then, prudence would suggest extreme caution in this arena. AD REFERENCES 1. Motel S. Six Facts about Marijuana. Pew Research Center. http://www.pewresearch.org/fact-tank/2015/04/14/6-facts-about-marijuana/. Published April 4, 2015. Accessed July 1, 2016. 2. Hedden SL, Kennet J, Lipari R, Medley G, Tice P. Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Rockville, Md.: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2015. Available at http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf 3. Controlled substance schedules. U.S. Department of Justice Office of Diversion Control. http://www.deadiversion.usdoj.gov/schedules/ index.html. Published May 2016. Accessed July 1, 2016. 4. Ingraham C. The DEA will decide whether to change course on marijuana by July. The Washington Post. April 6, 2016. https://www. washingtonpost.com/news/wonk/wp/2016/04/06/the-dea-will-decide-whether-to-change-course-on-marijuana-by-july/. Accessed July 1, 2016. 5. Ferner M. U.S. Surgeon General Vivek Murthy says marijuana ‘can be helpful’ for some medical conditions. The Huffington Post. February 4, 2015. http://www.huffingtonpost.com/2015/02/04/vivek-murthy-marijuana_n_6614226.html. Accessed July 1, 2016. 6. States Permitting Use of Medical Marijuana and approved indications. Pharmacy Purchasing and Products. http://pppmag.com/ documents/V11N11/pdfs/ppp_1411_medmarijuana_oo_tab1.pdf. Published July 31, 2014. Accessed July 1, 2016. 7. DEA Approves First-Ever Trial of Medical Marijuana for PTSD in Veterans [news release]. Multidisciplinary Association for Psychedelic Studies; April 21, 2016. http://www.maps.org/news/media/6141-press-release-dea-approves-first-ever-trial-of-medical-marijuana-for-ptsdin-veterans. Accessed July 1, 2016. 8. Plucinska J. Justin Trudeau takes a first step toward marijuana legalization in Canada. Time. November 16, 2015. http://time.com/4115711/ marijuana-legalization-justin-trudeau/. Accessed July 1, 2016. 9. Dowse MS, Shaw S, Cridge C, Smerdon G. The use of drugs by UK recreational divers: illicit drugs. Diving Hyperb Med. 2011 Mar; 41(1):9-15. DAN Cares Together, we save lives. Whether it is assistance provided over DAN’s 24/7 diving emergency hotline, an important discovery through our continued research, or application of emergency first aid – all of these elements directly impact diver safety. With your help, we continue to invest in these initiatives because we care. Together, we make a difference. DAN.org/DANCares All contributions are tax deductible and benefit the DAN Foundation, a 501(c)(3) organization, Tax ID # 56-1696689. ALERTDIVER.COM | 53

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