Chris Christensen either is a caring, compassionate doctor who dutifully cares for patients with chronic pain, or a calculating criminal who provided an easy path to pain pills for addicts, based on opening statements Monday in his negligent homicide trial.
As the 12 jurors and six alternates listened intently, the prosecution and defense attorneys laid out their version of the case, promising to tell different stories. The trial could last for a month.
Ravalli County Deputy Attorney Thorin Geist portrayed Christensen as a type of pill mill doctor who asked few questions and wrote plenty of prescriptions, which led to two counts of negligent homicide, nine counts of criminal endangerment, and 11 counts of distribution of dangerous drugs.
“The drugs prescribed had the highest risk of addiction and for abuse,” Geist told the jurors. “The defendant knew how dangerous the drugs were; not just because he was a physician and went to medical school, but he had been warned before” when he was sanctioned in Idaho.
A 2006 case against Christensen involving the death of one of his patients in Idaho was dismissed; he was acquitted there in a separate criminal action filed in 2005 involving dispensing controlled substances. Christensen didn't admit to any liability, but agreed to surrender his medical license for two years.
Defense Attorney Josh Van de Wetering countered that Christensen is one of a dwindling number of physicians around the nation who will treat patients with chronic pain because many doctors fear they’ll be prosecuted for prescriptions in high enough doses to provide relief. He readily acknowledged that patients may have lied to obtain medications, but added that many of Christensen’s patients were previously seen by other physicians and came to him with pre-existing conditions.
“He cares about his patients,” Van de Wetering said. “Is he perfect? Of course not. … What he is, in the words of his wife, is compassionate to a fault. That’s not a crime.”
With photographs of the alleged victims displayed to his right, Geist, the prosecutor, told the personal story of each. Some already were addicted to opioid drugs before going to see Christensen at his office, first in Victor and later in Florence. Others became addicted afterward.
According to Geist:
Gregg Griffin was an eight-year drug addict whose mother found him dead after he took two drugs — Xanax and methadone — together that were prescribed by Christensen. Kara Philbrick-Lenker was in chronic back pain, but after her original doctor refused to increase her methadone dose she turned to Christensen and overdosed three days later, when she combined his prescription with one from another doctor and alcohol.
Erica Cummings was dealing drugs from her home using a prescription that she got from Christensen. Paul Peterson was a promising golfer who became addicted to pain medications after seeing Christensen for knee and back pain. Jacqueline Golden and Heather Sutherland were mothers who no longer could parent appropriately after filling prescriptions from Christensen.
Jennifer Hiscoe was being treated by another doctor for chronic pain and depression after finding her son dead from a suicide, and is still battling addiction after being prescribed a variety of drugs by Christensen. Daniel Lieberg fell down the stairs and broke his back, later allegedly calling Christensen “the best drug dealer ever.” Todd Gore, a drug dealer from North Dakota, walked into the clinic with crutches and a back brace, and walked out carrying the crutches and a prescription for pills that he later sold in the Bakken.
Michelle Jessop had track marks up and down her arms from drug injections, but had no problem getting opioid prescriptions from Christensen. And even Ryan Marchand, an addiction counselor who worked with Christensen at times, became an addict after seeking help for pain from a neck fracture that didn’t heal properly.
“First, do no harm is a fundamental principle of medicine,” Geist said. “The defendant ignored that when he began writing prescriptions outside the accepted standards of medical practices.”
But Van de Wetering also offered stories about his client and the patients, many of whom were low-income and desperately seeking relief from chronic pain. He noted that much is still unknown about how pain works in our bodies and how different people respond differently to the same medications. Another story he will tell jurors is how chronic pain and addiction can go together for some people.
“This case is a bunch of different stories, interrelating with the difficulties of being human beings – the challenges, victories and defeats for the doctor, families, victims and people who work around them,” Van de Wetering said. “It ain’t easy.”
Accepted standards for pain medications are fairly new, controversial, vague and difficult to follow, Van de Wetering said, adding that there is no upper limit that can be prescribed. But with the current “opioid epidemic” and subsequent crackdown by the Drug Enforcement Agency (DEA), some doctors are refusing to increase medications or even treat patients with chronic pain out of the fear they’ll find themselves in Christensen’s shoes.
“One other story in this case is how the government is pushing and scaring and frightening pharmacists, doctors and their patients,” Van de Wetering said. “The federal DEA is going to pharmacies, putting pressure on them to not fill prescriptions for Dr. Christensen’s patients.”
Fear of retribution by the DEA prompted Christensen to keep limited notes, but he did reach out to local police to try to ensure that his patients weren’t re-selling their prescriptions, Van de Wetering said. Instead, “they determined that he was a criminal” and conducted their investigation to prove their theory.
Another reason for Christensen’s somewhat vague notes on patients was that he didn’t accept insurance so he didn’t have to do the paperwork that other physicians needed to get paid from the insurance companies. Van de Wetering added that the patients in this case are 11 out of roughly 600 patients prescribed opioids by Christensen, and only a fraction of his 5,000 patients overall.
“Patients come to him because they hear that he will respect you and take care of your pain even when other doctors have turned away,” Van de Wetering said. “He is a compassionate man to a fault. He has a soft spot, and he’s an easier target for people who are determined to lie to him. What you will not hear is that he’s a criminal.”