If you watch or read the news at all, you're probably aware that Anna Nicole Smith's former lawyer/boyfriend and two of her doctors are on trial for multiple charges related to giving her excessive prescription pain medications when they knew she was an addict. 

Although I don't usually follow celebrity trials, there are aspects of this one that could set a legal precedence which would impact the way chronic pain patients are treated in the future.  So I'm following this particular trial with great interest. 

There are many questions that need to be answered at this trial.  One of the most important is whether Anna Nicole Smith was truly a drug addict, simply a chronic pain patient who was dependent on her pain medication and had built up a tolerance, requiring large doses to relieve her pain, or both.  (See Opioids: Addiction vs. Dependence)

Other significant questions include: Did the doctors prescribe too much medication?  Did the lawyer/boyfriend give her too much medication?  Did Smith take more than the prescribed dosage of medication on her own?

According to witnesses who testified at the trial, Smith suffered from chronic pain syndrome, seizures, fractured ribs, migraine headaches, insomnia and severe back pain, as well as depression following her son's death.  The list of medications she had been prescribed included Methadone, Dilaudid, Demarol, Valium, Xanax and Chloral Hydrate.      

Three Cheers for the Judge

I like the judge in this case – Superior Court Judge Robert Perry.  He is intent on finding the truth and seems to understand the difference between addiction and taking opioids for pain relief.  Perry, who seems to have done a great deal of research relating to this case on his own, gave both the prosecution and the defense a list of 50 questions about the charges.  His first question: "What evidence shows that Anna Nicole Smith took drugs to get high or obtain a euphoric state and not to relieve pain?"  Way to go, Judge Perry!

After the prosecution presented evidence that thousands of pills had been found in Smith's homes following her death, the defense presented a pain management expert who testified that even if she had been prescribed 1,500 pills in a month for pain, it didn't necessarily mean she was an addict.  He said that clinical factors as well as her high tolerance for opiates and sedatives had to be considered.  Judge Perry apparently felt this was an important issues as he advised jurors, "The number of pills is not a determinative factor in this case. Please keep that in mind."

My Thoughts...

As far as the guilt or innocence of the defendants, I have no idea.  That is for the judge and jury to decide.  I'm just pleased there seems to be an understanding – by the judge at least – that taking a lot of opioid pain medications doesn't necessarily mean a person is an addict.  I'm glad there's not a rush to judgement, especially since much of the media had already convicted the defendants, judging by their coverage in the weeks following Smith's death.