On Friday, October 30, 2009, Superior Court Judge Robert J. Perry, concluded the preliminary hearing in the case against Howard K. Stern, 40, psychiatrist and former neighbor, Khristine Eroshevich, 61, and physician, Sandeep Kapoor, 41, who fed a steady stream of deadly drugs to Anna Nicole Smith (“ANS”), which ultimately led to her death two years ago at age 39. One of the final pieces of prosecutorial evidence was the transcript of an investigator’s interview with a friend who said she saw Stern placing pills in her mouth. “He poured them in her mouth like you would a bird,” Gina Shelley said in the interview. Defendant Stern is charged with 11 felony counts, including prescribing a controlled substance to an addict; obtaining a prescription by deceit; fraud and conspiracy. Defendants Eroshevich and Kapoor each face six felony counts.
Judge Perry decided that “the proof is sufficient to bind them over for trial.” Judge Perry’s ruling essentially equates to a determination that a reasonable person would suspect these defendants committed the crimes. So now this three ring circus will appear December 11, 2009, to be arraigned on the charges.
In the meantime, I interviewed psychological expert, Dr. Karin Schwartz, a Licensed Clinical Psychologist, who has a private practice at the Cedars-Sinai Medical Towers in Los Angeles. Dr. Schwartz has years of experience treating celebrities struggling with addictions, and worked as a primary therapist at the infamous Promises Rehab in Malibu. She also performed forensic psychological evaluations and treatment to inmates in the Bay Area, as well as judicial consultations. According to Dr. Schwartz, “there is no doubt that professional boundaries were quite blurred in this case and several unethical dual relationships were occurring which would constitute malpractice at the very least.” When I asked her about patients receiving such heavy dosages of the particular medications involved in this case, she responded that “such cocktails were a recipe for pharmaceutical suicide.”
Dr. Schwartz then added that “all one needed to do was observe two minutes of Anna Nicole Smith on the reality television show to see she was close to hitting rock bottom in her polysubstance abuse/dependence, and apparently had multiple enablers surrounding her at all times.” ANS “obviously never learned how to cope with feelings of grief, trauma, loss, and anxiety, to name a few, and it appears she found the correct ‘professional’ groupies to perpetuate her drug abuse to the unfortunate point of death.” Dr. Schwartz further opined that “secondary gain by her caretakers/enablers may have played a significant role in maintaining her level of addiction, since they never provided her the tough love needed in order to attempt to get her sober and perhaps ultimately keep her alive. Treatment protocol would have been, at a minimum, thirty days of residential treatment including medical detox and psychotherapy to begin to address the underlying psychological issues, followed by intensive day treatment and sober living. This would require a multi-disciplinary team of experts to address the physical, psychological and spiritual aspects of her addiction. Keeping her sedated in the Bahamas, following the unfortunate death of her son, absent therapeutic intervention, may have perpetuated her downward spiral and death.”
The California Department of Justice, Bureau of Narcotic Enforcement, launched a real-time access Prescription Drug Monitoring Program (PDMP) system which allows pre-registered users including licensed healthcare prescribers eligible to prescribe controlled substances, pharmacists authorized to dispense them, law enforcement, and regulatory boards to access real-time patient controlled substance history. California Attorney General, Edmund G. Brown, Jr., said if doctors and pharmacies have real-time access to controlled substance history information, then it will help them make better prescribing decisions and cut down on prescription drug abuse in California. I asked Dr. Schwartz about the state’s database, known as the Controlled Substance Utilization Review and Evaluation System, C.U.R.E.S, and she said “having this monitoring system in place will hopefully minimize patients using their physicians as drug dealers to perpetuate the abuse.” In sum, Dr. Schwartz feels that “apart from the death of Anna Nicole Smith, this last year alone we have witnessed the early deaths of Michael Jackson, Heath Ledger, and DJ AM, whose autopsies revealed that their deaths were due to pharmaceutical overdoses as well, and perhaps a monitoring system like C.U.R.E.S will enforce the notion that doctors need to be more conservative and mindful of patient history instead of possibly perpetuating drug seeking behavior.”
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I don’t think I would ever be saying this and it should be used only by physicians and people that have complex understanding of what is right for the patient but the C.U.R.E.S. system is becoming essential. Sometimes there is no other way then to find out the truth.. Think of all the jeopardy to patients lives that could be avoided and doctors that could protect their licenses. I would use it at least 30 times a year if it were available. A big thumbs up. For the record I have only ended up having to send 2 patients of 10,000 prescriptions to rehab and both of them asked me to… so far so good.
There needs to be serious regulation when physicians are dealing in serious drugs. When you have a culture of enablers and hangers-on who are aiding and abetting their “meal ticket’s” addiction then there needs to be a watchdog to make sure everything is on the up and up and that sound and ethical medicine is being practiced. In Anna Nicole’s case it is quite obvious that her enablers (i.e. her attorney and closest “friend” Howard K. Stern and her DOCTORS!) were not kept in check and as a result we have a woman who passed away well before her time. Because celebrities are in a unique position to have entourages dependent on them and also have the resources to sustain such advanced drug addictions they are particularly vulnerable to the sorts of crimes that Anna Nicole fell victim to and so an effective mechanism to guard against this rampant enabling is an absolute necessity.
punishment for doctors prescribing ridiculous doses of narcotic to patients who are rich..should be increased several fold…..i am tired of hearing about doctors abusing their privilleges of writing prescriptions.
Greedy doctors – too many of them out there. I enjoyed the interview with Dr. Karin Schwartz who clearly explained even though she understated the problems.
Can you explain more what C.U.R.E.S does?
I agree- but i think that the most important part of this whole proceeding is the attention that is being drawn to the issue of celebrity enabling. NOW HEAR THIS HOLLYWOOD: you will be liable for your actions- even if they are actions taken with a celeb.
I’m with the above–this is just another example of a culture that celebrates celebrity by saying nothing but yes. It’s horrifying that not one of these people who claimed to love her and/ or took an oath to do her no harm had enough integrity to do what was best for her.