Flash Trash: The Arrest of Dr. Warren Stack

Flash Trash: The Arrest of Dr. William Stack; Alexander DeLuca; War on Doctors/Pain Crisis; 2007-05-18. Revised: 2007-05-19.

From Salt Lake City: Police Arrest Murray Doctor over Painkillers - He Allegedly Ok’d Millions of Doses, Including Oxycontin by Jason Bergreen, Salt Lake Tribune, last updated 2007-05-17.< /p>

This article is worthy of study by students of the War on Doctors as it is absolutely typical of how most War on Docs prosecutions begin.

Almost all such government actions begin with a highly publicized raid on the doctors and initial media smear. (Sometimes all that is required to meet the government’s ends is the raid and smear, and no charges are ever filed. See recent post to this blog: DEA Mum [2 Years After] Raid on Dr. Nelson’s Office)

I won’t bother fisking the entire article. The more interesting part for our purposes is the second half of the article where arresting officers ejaculate over the “staggering” doses involved. But the first half of the article sets the tone, so let us take a brief look at an excerpt, paragraphs four through six, and eight:

“Dozens of patients were at Stack’s office when police arrived.
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“‘There was standing room only in the waiting room and people were standing outside,’ Jaroscak said. ‘As we arrived, they left.’ [Go figure. -alex]
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“Investigators watching the street said people in cars hoping to fill prescriptions continued to arrive at Stack’s office during the search.”
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“‘It appeared to us he seemed to be a well-known source of prescription painkillers,’ Jaroscak said.” [Well, that would describe a pain doctor; hell, he's probably in the Yellow Pages, too]

Fascinating. What is described is a busy medical practice being disrupted by a police raid. But the tone and implication are clearly that a busy medical practice involving the medical treatment of chronic pain is probably illegal. Which makes chronic pain patients presumptive criminals.

The government is trying to encourage tacit agreement with DEA’s core belief in magic substances that turn some users into criminal addicts requiring long term incarceration, to be distinguished from deserving pain patients who may morph into criminal drug addicts at any moment. This is gibberish and nonsense, of course, promulgated by the very same police forces that invented and that perpetuate the real drug problem in America - prohibition.

Even more interesting to me is the part of this initial media smear on Dr. Stack that concerns the amounts of medication involved in the practice, because at the core of almost every War on Docs prosecution is the entirely medically incorrect assertion that high dose therapy is ‘outside the bounds of medical practice’ or beneath the ’standard of care. [For an explanation of these terms and their prosecutorial misuse, see: The Bounds of Medical Practice and the Standard of Care]

“Jaroscak said Stack was distributing about half a dozen types of pain medication including, Oxycodone, OxyContin, Xanax, methadone and about 3.5 million doses of Hydrocodone…” [Imagine! A doctor using SIX different medications in his practice (gasp!).]
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“The Utah Division of Occupational and Professional Licensing (DOPL) and Medicaid’s fraud unit were able to track Stack’s prescription DEA number and history to 2001 to determine how many doses he had issued, Russo said…” [See: Do We Really Want e-Prescription Monitoring?]
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“Jaroscak said this bust was at least 10 times bigger than any other bust he had heard of…”
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“Our concern [in Stack's case] is the sheer amount,” Jaroscak said. [Yup, and that is the problem]

Wow. 3.5 million doses of hydrocodone - “nothing short of staggering” as the cops said, right? Wrong.

This, dear fellow students, is FLASH TRASH, a common statistical trick of drug warriors. Flash Trash is: “The use of suggestive of provocative numbers or statistics, usually presented as true prima facie, which when analyzed using algebra, do not in fact support the implied conclusion.”

Let’s do some math. I present a hypothetical:

Assume I prescribe to every patient 1 5mg pill of hydrocodone to be taken every four hours. This is not high dose therapy by any stretch of the imagination. OK, 6 pills a day X 365 days/year = 2190 pills per year per patient.
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If I see eight new patients a day, four days a week, 50 weeks a year: 4 X 8 X 50 = 1600 new patients a year.
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1600 patients taking 2190 pills a year = 3,504,000 pills = “3.5 million doses of hydrocodone.”

Classic Big Lie tactics. See how this works? A perpetual drug crisis is declared. Then raid the doc and commence initial lurid media smear with statistical trickery - some combination of Outcome Obfuscation, Denominator Abuse, Flash Trash, or Shock Schlock - added to give it all an authoritative veneer.

You can see this tactic employed in Hurwitz, Rottschaefer, Fisher, Knox/Boone, Heberle, Nelson, and Paey, to name just a few, unfortunately.

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