Carter drug use described as "out of control"

After the jury returned from lunch, Bill Jacobs, a Jacksonville physician specializing in pain management and addiction, continued testimony about the drugs Carter used in the months before his overdose death.

Defense attorney Donald Samuel asked how Jacobs could have possibly known Carter would die from the drugs prescribed to him by Chua, as he described in earlier testimony Wednesday.

Jacobs described Carter's drug use as "out of control," based on his prior medical history and by the number of drugs prescribed to him by Chua and other doctors.

He said "it is usual behavior" for someone with a substance abuse problem to keep multiple prescriptions of unused drugs, even if other medications were prescribed to replace them.

"I believe it's likely the drugs came from Dr. Chua and other sources," Jacobs testified. "Addicts take anything that's available."

It's unclear where the morphine found in Carter's system came from, he told jurors. High levels of oxycodone were found in Carter's blood by medical examiners, Jacobs said.

Though Chua changed Carter's medications many times, Jacobs said he "did not see any instructions to stop taking anything."

During Jacobs' testimony, Judge Amanda Williams sent jurors to their chambers to settle a disagreement between the attorneys for the prosecution and defense about earlier testimony regarding photographs of drugs found in Chua's home.

"I want to be able to respond to show it wasn't careful testimony," Samuel said.

Williams said she will instruct the jury about the disagreement between attorneys and ask them to use their own recollection about earlier testimony.

"We can't even agree what happened," Williams said. "I'll have to say the record is unclear. Nobody in the courtroom has a record about what happened."

Jacobs said his medical opinion had nothing to do with photographs of pills and containers found in Chua's home.

Jacobs said Carter's death was not unexpected, considering his medical history. Jacobs said he believed Carter took all the medications prescribed, despite Samuels contending it would be impossible for Carter to take all the medications such as 90 methadone pills and 90 oxycodone pills in one week.

"I don't know how many he took," Jacobs said. "Addicts rarely have left over drugs."