UGK's 'Pocket Full Of Stones' is pure, unfiltered rap. Bun B and Pimp C rap about having pockets full of crack, referring to freebasing, dope fiends, pipes and pregnant women clucking for a crack fix. It's one of the realest - and grimmest - hip hop tracks about cocaine going, but - paired with a sleazy, winding funk beat - makes you feel like you're witnessing it all first hand in the front seat of UGK's Cadillac while driving through the streets of their hometown of Port Arthur, Texas. Be sure to watch drug dealing classic Menace II Society to grab a listen of 'Pocket Full Of Stones' as well.
We conducted an online survey of NSP managers across Canada to estimate the proportions of NSPs that provide education and distribute safer smoking equipment to people who smoke crack cocaine. We also assessed change in pipe distribution practices between 2008 and 2015 in the province of Ontario.
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Analysis of data from 80 programs showed that the majority (0.76) provided education to clients on reducing risks associated with sharing crack cocaine smoking equipment and about when to replace smoking equipment (0.78). The majority (0.64) also distributed safer crack cocaine smoking equipment and over half of these programs (0.55) had done so for less than 5 years. Among programs that distributed pipes, 0.92 distributed the recommended heat-resistant Pyrex and/or borosilicate glass pipes. Only 0.50 of our full sample reported that their program provides clients with containers for safer disposal of used smoking equipment. The most common reasons for not distributing safer smoking equipment were not enough funding (0.32) and lack of client demand (0.25). Ontario-specific sub-analyses showed a significant increase in the proportion of programs distributing pipes in Ontario from 0.15 (2008) to 0.71 (2015).
Data were downloaded, managed, and analyzed using SPSS (version 24). Specifically, we report frequency distributions and bivariate statistics to characterize the proportion of programs offering safer crack cocaine smoking education and equipment distribution by NSPs. In addition, using data from an earlier study that used the same online survey methods for Ontario [25], we compared the proportion of programs in that province that distributed pipes in 2008 versus 2015. Similar data were not available for the other provinces or territories.
A majority of participants (0.76) reported that their program provides education to clients on reducing risks associated with sharing crack cocaine smoking equipment. Further, 0.75 indicated that their program provides education on identifying risks, such as cuts and injuries, from the use of improvised smoking equipment (e.g., soda cans as makeshift pipes), and 0.72 reported that they provide education on how to use safer smoking equipment.
Over three quarters of participants (0.78) reported that their program staff advise clients about when to replace smoking equipment. In terms of specific instances when it is time to replace smoking equipment, 0.75 of managers reported that their program advises clients to replace pipes and/or mouthpieces if these items have been used by anyone else; 0.74 advise clients to replace their pipe if it is scratched, chipped, or cracked; 0.71 advise clients to replace mouthpieces that are burnt; and 0.70 advise clients to replace the screen if it shrinks and becomes loose in the pipe.
Our study indicates an ongoing need to investigate and address barriers to best practice uptake, as 35% of managers in our sample reported that their program does not distribute any safer crack cocaine smoking equipment. More work is needed to address other domains found to promote uptake of evidence-based recommendations, including nurturing champions of organizational change, organizational cultures that support innovation and leaderships that promote the use of evidence-based practice, and ensuring adequate funding streams for distribution and disposal of safer smoking equipment [33, 34]. Only two managers among those who said that their programs do not distribute pipes selected police opposition as an underlying reason. This finding seems consistent with results from our larger evaluation study which show that the majority of NSP managers we sampled reported mostly positive relationships with their local law enforcement [35]. However, interpretation of this finding is difficult in light of other research that has reported policing practices to be a barrier to services designed for people who smoke crack cocaine (e.g., [19, 24]). Police support and opposition regarding harm reduction programs are dynamic, though, for example, in Canada there are signs that police perspectives on supervised injection facilities have changed in recent years, seemingly linked to the opioid overdose epidemic (cf. [36, 37]). How police may view services for people who smoke crack cocaine and how those views are changing or may change are worthy of in-depth investigation.
Lastly, although collection and safer disposal of used injection equipment is a core activity of NSPs, including providing clients with rigid, tamper-resistant, and clearly labeled sharps containers (see [27] for evidence-based best practice recommendations regarding disposal and handling of used drug-use equipment), we found that only half of all NSPs that we sampled provide clients with containers for safer disposal of used smoking equipment. We did not include more detailed or follow-up questions about this issue in the online survey, so we are unsure if this lack of safer disposal container provision represents a resource or cost issue and/or something else. We know from anecdotal reports from members of the cross-regional, multi-stakeholder best practice team that cost can be a barrier and some programs already struggle to cover the costs of injection equipment disposal. It is also possible that NSP staff do not regard pipes and other safer smoking equipment as sharps and/or biohazard material requiring the same level of safety procedures as used injection equipment. The removal from circulation and safer disposal of used injection equipment have long been considered key elements of NSP strategies to reduce needle reuse and accidental needle-stick injuries which, in turn, reduce opportunities for infectious disease transmission [38, 39]. More research is needed to determine if disposal is similarly as important for reducing certain risks associated with crack cocaine smoking.
Wind chill plays a significant role in freezing pipes, too. If unheated spaces have holes, cracks or openings that allow cold, outside air to blow in, the cooling effect often accelerates ice formation. Even small openings can allow a dangerous amount of cold air into a structure, like the small holes that let telephone, cable, internet or television lines enter a room.
However, this is not a hard-set rule. Depending on their exposure to wind and the elements, pipes can freeze when temperatures are higher than 20 degrees. In interior spaces, if pipes are near cracks or openings that let in cold air, they may develop ice blockages even if they are in a heated space.
Later in the winter, when wind chill factors drop into the single digits or the area experiences extended periods of extreme cold, there are some additional precautions that people can take to protect their pipes:
Pipes in attics, crawl spaces and outside walls are all vulnerable to freezing, especially if there are cracks or openings that allow cold, outside air to flow across the pipes. The size of pipes and the type of pipe (copper or PVC) have some effect on how fast they freeze, but they are relatively minor factors in pipe bursting compared with the absence of heat, pipe insulation and exposure to a flow of subfreezing air.
Another precaution to take, if you decide to leave town for the holidays, is to turn the water off at the main shut off point. This way, even if your frozen pipes do crack, you will have much less damage to deal with.
During a sudden cold wave, an open faucet can serve as a relief valve for the pressure that builds in pipes when they freeze. This pressure relief can prevent your frozen pipes from cracking, or worse, bursting. While the trickling water will add to your water bill, it will spare you some major home and plumbing repair costs.
First, the conditions must be right for the water in your pipes to freeze. If temperatures are going to be below freezing for a sustained period of time, frozen pipes are a possibility. That's going to be true for this weekend as we'll have temperatures well below freezing and wind chills near negative 10.
Exposed pipes are at risk for freezing and wind chill can cause pipes to freeze when cold air gets into unheated spaces through cracks and even small holes for cable and phone lines. Pipes in spaces like attics, basements and garages are susceptible to ice blockages. 2ff7e9595c
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