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Trial's pivotal issue: Was Anna Nicole an addict, or in pain?

By Alan Duke, CNN
Anna Nicole Smith died on February 8, 2007, from "acute combined drug intoxication" according to a Florida medical examiner.
Anna Nicole Smith died on February 8, 2007, from "acute combined drug intoxication" according to a Florida medical examiner.
  • Smith's doctors are charged with using fake names on drug prescriptions
  • Her boyfriend also is charged in a conspiracy to provide drugs to an addict
  • A defense lawyer says Smith was not an addict, but she was seeking pain relief
  • The reality TV star died of "drug intoxication" in 2007

Los Angeles, California (CNN) -- The use of powerful drugs to treat complaints of chronic pain, and the faking of names on prescriptions for celebrities are central issues in the trial of Anna Nicole Smith's last two doctors and her lawyer-boyfriend.

A Los Angeles County jury heard opening statements Wednesday in the trial of Howard K. Stern and Drs. Khristine Eroshevich and Sandeep Kapoor, charged in a conspiracy to provide drugs to an addict.

A defense lawyer said Smith was not a drug addict, but was a victim of chronic pain who was seeking relief. The doctors, who never found the cause of her pain, were doing their best to relieve it with drugs, while her boyfriend, Stern, was going along with their treatment plan.

The use of fakes names was a routine way to hide Smith's medical information from prying tabloid journalists who would pay medical workers to leak it, Steve Sadow, Stern's defense lawyer, told jurors.

Video: 2009: Arrest warrant for Stern

"It's not a murder case," Sadow said. "It's a prescribing medications case."

The prosecutor outlined the last three years of Smith's life, which ended in a Florida hotel room because of "acute combined drug intoxication" on February 8, 2007.

The three defendants illegally conspired to fuel the actress-model's drug addiction with excessive amounts of powerful medications, Deputy District Attorney Renee Rose said.

The doctors crossed legal and professional boundaries because they were captivated by Smith's fame, Rose said.

"We trust doctors to act responsibly... even in spite of ourselves," Rose said.

Kapoor began prescribing painkilling opiates and anti-anxiety benzodiazepines to Smith in 2004, Rose said. He used the alias "Michelle Smith" on the opiate prescriptions, she said.

Eroshevich, a psychiatrist, also was prescribing powerful drugs to Smith using fake names, Rose said.

Stern "facilitated" the prescriptions, sometimes calling the doctors and picking them up from the pharmacy, Rose said. He was motivated by the millions he would gain if she won a court battle against her deceased husband's heirs, Rose said.

Anna Nicole Smith's appearance on the 2004 American Music Awards telecast showed how she was affected by the drugs, she said. Jurors watched a video clip which opened with Smith asking, "Like my body?"

Smith was not a drug addict, Sadow said. She sought the medications for "real pain, constant pain, chronic pain."

"She took the prescription medicines for her pain, primarily due to the inadequate control of pain," Sadow said. "No physician was ever able to determine why she had pain."

Stern, who is a lawyer but not a doctor, "relied on the good faith of the medical judgment of the doctors," Sadow said. "He relied on their judgment of what was medically necessary for Anna."

It could not be a conspiracy because Stern did not know it was wrong or that using false names on prescriptions was illegal, Sadow said.

"Celebrities in Hollywood use aliases all the time," he said.

Sadow said Kapoor was giving the same drugs and used the same alias as her previous doctor, whose practice he bought. That doctor has not been charged.

Other doctors also used false names for Smith, including at Cedars-Sinai Medical Center when Smith was treated in 2006, he said.

"Every time she would have interaction with the medical community, it was under a different name," he said.

Her identity was not secret to the pharmacist who regularly filled her prescriptions, he said, but Smith feared medical workers would sell her information.

"She was fodder for the paparazzi and that's where 'Michelle Chase' came in," Sadow said.

The trial is expected to last up to three months.