Utah / Feds Boldly Move Toward Solution to Addiction

Utah and Federal Law Enforcement Collaborate Towards a Final Solution to the Prescription Drug Abuse Plague; Alex DeLuca; War on Doctors / Pain Crisis; 2007-05-30. Revised: 2007-05-31.

From Salt Lake City comes this article: Does Doc Bust Mean Crime Wave? - Law Enforcement On The Alert, Treatment Offered For Addicts; Heather May; The Salt Lake Tribune; 2007-05-26.

“With the arrest of a doctor who may have prescribed millions of doses of painkillers, police and prosecutors fear a new crime wave.” [see: Flash Trash: The Arrest of Dr. Warren Stack; DeLuca; War on Doctors/Pain Crisis; 2007-05-18]…

“If they become addicted to prescription drugs, we in Salt Lake County stand ready to help,” said County Mayor Peter Corroon at a news conference Friday. “People can recover.”

I am almost speechless - this is truly an evolving public health / medical ethics / civil rights / law enforcement / political debacle in the making. This is one of those rare moments in civics when we the people get to see with painfully clarity where our leadership has brought us, what their beliefs and values really are, and the ’systems’ and responses those produce.

This is a very disturbing and shocking story, but it is not a long one, nor particularly complicated.

1. Dr. Stack gets arrested in the usual, completely unnecessary, overly aggressive, multi-agency police raid of a busy medical office full of variously ill and terrified patients. Typical media smear ensues, this one quoting law enforcement hyping up the magnitude of the “bust”, and so on. We’ve analyzed a few of these lately, so let’s just move on. [see also: Pain Doc Volkman Speaks Out Against DEA in April - Gets Indicted in May; DeLuca; 2007-05-26]

2. The patients who didn’t run away got to watch their personal and confidential medical records being stolen by swatted-up cops. Any chance for legitimate pain patients to find substitute chronic pain care just vanished to lock-up. But it wouldn’t really have made much difference; there won’t be many docs stepping up to provide compassionate pain care - not in Utah - any time soon. Especially for past-patients of Dr. Stack. So far, all this is just the usual brutality.

3. Here’s where it starts to get twisted, even for a gnarled veteran of the ‘pain management’ rabbit hole like me. Law enforcement officials are long gone on a hype binge by now, and it’s hard to stop, of course. So within a few days we see the shutting down of a medical practice morph into visions of hundreds?, thousands??? of “drug addicts” unleashing a terrifying crime wave on SLC. “We’re concerned,” [District Attorney Lohra Miller ] said. “A person addicted to pain medication may turn to heroin.”

A person addicted to pain medication may turn to heroin - D.A. Lohra Miller

4. Please Note the complete conflation of “addiction” with “dependence on pain medication.” Also, no mention yet of the suddenly abandoned patients. And. There. Won’t. Be. Those poor souls who need opioid pain medications to function and survive, having been cleaved from their physician by law enforcement, are now criminals, not patients. Just a bunch of people “addicted to pain medicine [who might] turn to heroin.”

A person addicted to pain medication may turn to heroin - D.A. Lohra Miller

5. Re-enter “County Mayor” Corroon; after all, something has to be done!

“If they become addicted to prescription drugs, we in Salt Lake County stand ready to help,” he said, “People can recover.”

The county is publicizing its support services because of… up to 5 million doses of painkillers that may have then been illegally sold throughout the Salt Lake Valley.

Recover from what, exactly?

6. Now it gets sinister. A busy pain medicine practice has been shut down, and not one journalist or law enforcement officer or medical board official has expressed any concern at all about the patients. It isn’t even clear that any of the above have even bothered to find out how many patients we are talking about. All eyes are glued to the policeman’s movie, entranced.

7. And so of course, with all agencies charged with protecting the public good asleep at the switch (except law enforcement), really, really bad ideas are had and schemes, either ignorant or venal - it remains to be seen, begin to congeal.

Pat Fleming, director of the county’s substance abuse division, assured the addicted that if they seek treatment, the county would not divulge their names to prosecutors - or anyone.
(I’m sure the patients whose confidential medical records were stolen at federal gunpoint will be comforted by these probably sincere but utterly groundless reassurances. -alex)

“We don’t want to have them come in [and] try to arrest them,” [Fleming] said… Corroon said he may have to dip into the county’s savings if there is a major influx in patients.
(See, I could tell he was a can-do kind of guy! -alex)

This is getting ugly. Now we have clinicians weighing in and still no cognizance of the plight of Dr. Stack’s legitimate pain patients, and no effort to mobilize any sort of coherent medical response. In fact, so far there are no medical authorities dealing with the situation at all.

8. So, what have we got? We have local officials running around preparing for a hypothetical law enforcement problem the policeman is hyping. Through some horrific leap of irrationality and probably criminal negligence, state and local officials have taken law enforcement’s worst case scenario - that the doctor was a drug dealer, all of his “patients” criminal addicts, all the meds all of them were ever prescribed were 100% diverted to high school students leading to generations of misery and crime for sure - and blotted out any notion that there might be a medically directed public health approach to consider. And no criminal charges have even been filed yet.

9. And what about those suddenly abandoned pain patients facing imminent disabling pain compounded, in some cases, by withdrawal, that no one seems to want to remember exist? Well, my friends, you have not been forgotten by your benevolent government. You get to register as an official “addict” at the government clinic which will then take you off those pesky pain medications that, after all, got you into all this trouble in the first place. And you will learn to live with the pain and be polite about it. And of course you have a choice. You can choose to give us a hard time forcing us to call the policeman again, and we wouldn’t want that, would we?

I am terribly, terribly impressed. I am, in fact, awestruck. A DEA Tour de Force, and no mistake.

This is nothing less than an amazing local, state, and federal demonstration of near seamless cooperation toward a final solution of this tiresome prescription drug abuse problem:

Eliminate pain management doctors;

Send the poor dears off to their faith-based, drug-free fate.

Congressional commendations will surely follow; maybe this efficient process could become part of the next White House Drug Control Policy? Trust me, it could happen.

Then we could replicate it in your community.

Finally, while it is easy to make fun of local administrators and substance abuse counselors being bullied by the Dept. of Justice, I want to be very clear that these are most definitely not the worst actors in this tragedy, and certainly not those I am most disappointed in. Because we haven’t heard from the cowards yet. They include, alas, the usual suspects.

Conspicuous Cowards, so far:

The academic medical establishment, especially academic pain and addiction medicine, staring fixedly at their covered asses, mute;

Whatever passes for a State Board of Medicine in Utah - ever focused on becoming better cops, instead of ensuring that Utah’s citizens receive the medical standard of care (which Dr. Stack’s ex-patients most assuredly are not);

Every Public Health official in poor benighted Utah - what is wrong with you, why have you entirely abdicated your duties allowing a federal police agency and county-level officials to take command-and-control of your turf?

Every member at any level of the legal and law enforcement professions, and all elected officials in Utah, for entirely failing to make any effort to rein in your own. You are panderers.

The major, funded, drug policy and civil rights and pain foundation organizations who are playing it safe and waiting, waiting, waiting… But it’ll never be safe for the docs, patients, and drug users you claim to care about and represent, if you always play it safe, waiting, waiting, waiting…