Anytown, USA
Anytown Demographics
- Population:23,500 people
- Largest industry/employer is the coal mine.
- Coal mining operations have decreased in the past few years.
- Because of physical injuries, illnesses, and other ailments, opioid use has skyrocketed.
- Because of the economic downturn, opioid use as a coping mechanism has dramatically increased.
- An opioid overdose emergency occurs almost daily, many times resulting in death.
- The major has declared the opioid crisis as the number one crisis the town is facing.
The Coal Mine
- The largest employer of Anytown
- Over half of the employees have either qualifies for workman’s compensation or have an illness related to their working conditions.
- The most common condition is black lung
- Because this type of illness is directly related to working in the mine, working conditions need to be improved.
Steven Anderson
- Environmental Science Director for the county.
- Work experience has always been within public health.
- Has a particular interest in the connection between environment and opioid abuse.
- Has been working with the coal mine to improve safety conditions.
“I am the Environmental Science Director for the county that includes Anytown. By now, you know about the public health crisis generated by the opioid epidemic not only in Anytown, but across the country as well. In fact, the opioid crisis can be called the number one public health issue of our time. In fact, a White House Panel recommended that this be declared a national emergency (Goodnough, 2017). But did you know that this crisis and environmental science are connected? How, you may ask? Let’s look at the environment of a coal mine. Are the working conditions considered safe in terms of the air quality? One of the most common illnesses for coal mining workers is called pneumoconiosis, or black lung disease. According to the Centers for Disease Control and Prevention, pneumoconiosis occurs when someone breathes in dust particles, or in this case, coal particles, over a period of time. It often takes years for the disease to manifest, and when it does, lung impairment, disability, and even death can occur. This is an environmental science public health issue because this is a human-caused disease and can be prevented through proper dust control measures. Because there is no cure for black lung disease, many residents have turned to opioids to cope. I need your help with this problem. Put on your environmental science hat and let’s brainstorm ways to help our community and prevent this horrible condition and its aftermath.”
Landon Martin
- Research assistant for the Department of Health
- Working on his PhD in Biomedicine
- Tasked with reporting data related to opioid use.
- Knows that there is a disproportionate number of opioid prescriptions compared to residents.
- Needs help collecting public health data
“You know that research, data, and biostatistics are crucial for public health. This is how trends and patterns are determined and appropriate decisions are made about health promotion or intervention. I am a research assistant for the Department of Health here in Anytown; my days are consumed by quantitative and qualitative research. I have been tasked to determine the internal and external threats to Anytown from the opioid crisis. I have been looking at data from similar cities to Anytown, trying to determine if we can apply any of the lessons learned to help combat the growing numbers of opioid overdoses. Did you know that the CDC reported that 91 Americans die each day from an opioid overdose, and in the past 15 years, the number of deaths has quadrupled? Of those deaths, half were from prescription opioids. But in those 15 years, there has not been an increase in those reporting to be in pain. Why do you think there has been an increase in overdoses and the use of prescription opioids in recent years? I need some help collecting research. Do you have time to help me? There is just so much information out there that getting another set of eyes on the research will go a long way in helping me have the best picture of what we are up against.”
Heather Raymond
- Former opioid addict
- Stemmed from a back injury
- Needed more and more pills to mask the pain
- Could obtain multiple prescription from different doctors and separate pharmacies.
- Overdosed, survived and went to treatment for addiction.
- Committed to helping others with opioid addiction.
“When you look at me, do you think I look like an opioid addict? Well, I was. It all started off innocently enough. I had been having issues with my back to the point where I wasn’t sleeping and it affected my daily life. My doctor prescribed Percocet and it was amazing. I could finally sleep and the pain was managed while we were working on getting my back better. You have to get a doctor’s approval for more of the pain medicine, but that was easy. I was able to get refills from my doctor because my back problems took quite some time to solve. But by that point, I didn’t want to stop taking Percocet because I loved the way it made me feel. It was a prescription medication, so I thought it couldn’t be that bad. I was so incredibly wrong. At first, it was easy to get more pills. I had three different doctors writing me a script, and I went to three different pharmacies to get them filled. I know some doctors do a much better job of monitoring the amount of prescription pain medication they prescribe, but my doctors were too busy to notice. And with my insurance, the pills were pretty cheap. But there came a time when I got used to Percocet, and I had to take more than what was originally prescribed to feel that same feeling of floating and not quite being in control. Then, I discovered what happens when you combine the pills with wine. That did the trick for me, but it was also my downfall. I learned the hard way— by overdosing—that I had a real problem and that prescription drugs are just as deadly as illegal drugs. But I was one of the lucky ones. I survived. That was the turning point for me. I knew then I needed help, and help is what I got. But not everyone who overdoses and survives decides to get off the drugs. That is where you come in. I would love to help you understand the mentality of being addicted to opioids. As a former addict, I know what it takes to overcome that addiction. I know that the data collected on people like me can help make decisions for combating this growing problem. I was able to easily obtain these pills. I had risk factors. I know my story can help public health personnel make the right decisions for creating change. Let me know how I can help.”
Julie Damica
- Husband injured working in the coal mine.
- Became addicted to pain pills and then to heroin.
- Overdosed on heroin.
- Six-year-old daughter witnessed her father’s overdose.
- Learned husband was HIV positive, most likely from sharing needle
- Wants to help by promoting awareness about opioid addiction.
Carol O’Brien
- Director of the Department of Health
- Holds a graduate degree in public health.
- Has work experience in public health interventions, worked in sub-Saharan Africa to help HIV awareness and prevention, part of their relief efforts for Hurricane Katrina, and has a background working with women and children in difficult situations.
- Understands the skills and attributes needed to work within public health.
- Looking forward to the report you will be submitting to her in eight weeks.
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