HAMILTON, Mont. - The Florence doctor accused of over-prescribing drugs after his clinic was raided has taken the stand to defend himself.
He began his testimony after lunch Monday and continued through the afternoon. Dr. Chris Christensen faces 22 drug counts including two negligent homicides of patients under his care.
Christensen said he began treating patients when he was practicing in Kellogg, Idaho, in the 1990s. He said he believes chronic pain can be related to the economy involving social factors and unemployment. He said at the time the mining and logging industries in that area of the Idaho Panhandle were on a downward spiral.
He said many of the patients were miners and loggers who suffered terrible injuries.
"From falling down a mine shaft 40 feet," he said, "being electrocuted and having a tree fall on them."
Christensen said after a doctor's office was closed in his medical community a high number of opioid dependent patients came to him.
He said he had "sympathy, then empathy" for those patients.
Christensen said he referred most of those patients to more specialized care. He said the closest was at least 45 miles away. He said there were no addiction services in the community he was serving.
"Those patients had to find somewhere to go," he said.
The doctor said he "talked to people" about their chronic pain.
He said he grew to understand more about such pain in his own early family life.
He said his father was a prisoner of war in Germany during WWII and had been beaten while there.
He said it left his father with chronic pain, and that that pain and his father's alcoholism affected the entire family.
"I realized in a very palpable way," he said, "there were affects that untreated pain had on the dynamics of a family."
Christensen said he was "more than willing" to listen to leaders in the field at the time who began drawing attention to studies of large numbers of cancer patients who had been exposed to high dosages of opioids and did not become addicted.
Monday morning the defense called a pain specialist from Los Angeles. Dr. Forest Tennant told the court that Christensen was doing what many doctors across the country were doing. He said opiates were being prescribed as a "first line treatment."
Tennant said prior to 1996 the only physicians who prescribed narcotics were public health doctors with special licenses like himself.
He said after 1996 the federal federal government and much of the medical establishment initiated change.
"You had a standard in the country, " said Tennant, "that if a patient walks into see a doctor and said they had pain the doctor can prescribe anything in their judgment that they think can relieve the pain including opioid drugs."
They wanted every physician in the country including family doctors,said Dr. Tennant, "to begin treating chronic pain."
"I've always disagreed," with that he said. "It was a mistake."
"I was on the minority side saying that we would have these abuse problems," he said, "we're going to have overdoses. Family doctors shouldn't treat these people."
But that's now changed he said. He said it's gone back to the way it was before.
He said in 2016 the CDC enacted new standards that changed those guidelines to include non-drug treatment first.
He supports the new guidelines.
Tennant said Christensen was in "over his head" treating pain patients with opioids.
But he said Christensen is being blamed for what thousands of doctors were doing at that time. He said no alternatives have been given to these patients.
Tennant said he came to Montana to testify for Christensen free of charge.