Doctor: Smith complained of ailments but he couldn’t diagnose source of most pain

Tuesday, August 10, 2010

Doctor felt Smith used drugs for emotional pain

LOS ANGELES — A doctor who treated Anna Nicole Smith six years before she died testified Tuesday that she complained of many physical ailments but he was unable to diagnose the source of most of her pain.

Dr. Victor Kovner said he came to feel, “she was treating emotional pain with drugs designed for physical pain.”

Kovner said he warned Dr. Sandeep Kapoor, a doctor now charged with providing large amounts of prescription drugs to the Playboy model, that Smith could be manipulative.

Kovner offered the warning when Kapoor bought his practice. He also urged Kapoor not to socialize with celebrity patients, an issue that has arisen in the trial.

Kapoor was photographed riding with Smith in a gay pride parade, and prosecutors claim the social relationship clouded his judgment.

Kovner said he told Kapoor in 2003 that Smith had two diagnoses: chronic pain and addiction to prescription drugs.

His comments regarding addiction drew objections from a defense attorney. But Superior Court Judge Robert Perry reminded jurors that a key issue in the case is whether Smith was addicted to drugs.

Kapoor, Dr. Khristine Eroshevich, a psychiatrist, and Howard K. Stern, who was Smith’s boyfriend-lawyer, have pleaded not guilty to conspiring to provide Smith with excessive amounts of opiates and sedatives and to prescribing to an addict.

Perry told the jury the law says a person whose drug-seeking behavior is due to a need to control pain is not an addict.

“Substance abuse is a lifelong disorder,” Kovner testified, noting Smith told him she had been in rehab once for alcohol and Vicodin abuse.

He also said there were times when Smith asked for additional medication, mostly because she was afraid of running out of her pills.

He said he provided her with Dilaudid, Methadone and Topomax during the time he treated her, and she seemed to improve.

“She had the potential for being manipulative but she did respond to structure and when denied what she wanted she adjusted to it,” he said.

Asked to describe Smith’s personality, the doctor said, “I felt she was very childlike. She acted like a teenager.”

He said she spoke of many maladies including Reflex Sympathetic Dystrophy, a pain disorder, which he could not confirm.

“She had long lists of pain,” including migraines, back pain and intestinal dysfunction, he said.

Kovner, now semi-retired, said he had previous dealings with celebrity patients.

“Celebrities are known to often corrupt the judgment of good doctors,” he said. “An outstanding example is Michael Jackson.”

The judge ordered that comment stricken from the court record.

A month after Smith died, Eroshevich gathered 44 different prescription drugs from Smith’s seaside home in the Bahamas and delivered them to a medical examiner in Florida, according to Dr. Harold Schueler, chief toxicologist for Broward County, Fla.

Schueler said many of the bottles contained painkillers, opiates and sleeping medications. Methadone, phenobarbital and Valium were among the drugs found along with antibiotics and Tylenol, he said.

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