Wichita ? Federal prosecutors told jurors Tuesday they would hear a “sordid tale” of money over medicine during the trial of a Kansas doctor accused of providing painkillers to drug addicted patients. The defense, meanwhile, described the trial as a referendum on chronic pain treatment in America.

Dr. Stephen Schneider and his wife and nurse, Linda, are charged with conspiring to illegally distribute prescription drugs that contributed to 21 deaths, although court documents tie them to many more. They also are charged with fraud and money laundering.

Assistant U.S. Attorney Tanya Treadway told jurors during opening statements Tuesday that about half of the 10,000 patients treated at the Schneider Medical Clinic received pain medication. An indictment described the clinic as a “pill mill” that was open 11 hours a day every day and scheduled patients 10 minutes apart. Some patients received medications that they had already overdosed on, it said.

Treadway told jurors Schneider might have faced a malpractice case if there had been one or two overdose deaths. But with more than 100 overdoses and 68 deaths and no action from the Schneiders to address the problems, it became a criminal case, she said.

The Schneiders made a decision to put money before medicine, Treadway said. Their clinic — a sprawling medical facility with 14 exam rooms, two water fountains and sky dome in the lobby — made

$7 million in little over four years through health care fraud, while the Schneiders personally took out $1.5 million, she said.

But Kevin Byers, the attorney representing Linda Schneider, told jurors the fraud and money laundering charges were a “smoke and mirrors thing,” and the case was really about chronic pain treatment, the propriety of it, and the availability of medication for 7 million sufferers.

Lawrence Williamson, the doctor’s attorney, said prosecutors went after the Schneiders to protect insurance companies and government programs that didn’t want to pay for pain medication. They also targeted the doctor because he earned more than other physicians in the area, he said.

“You are going to learn treating pain patients is one of the scariest things physicians can do,” Williamson said.

He told jurors they needed to decide whether Schneider acted as a drug dealer or a doctor. If he acted as a doctor who truly believed people needed medication, the jury must find him innocent, Williamson said.

He insisted Schneider acted with a “pure heart.”

During afternoon testimony, the government played a brief video clip of a deposition in which Stephen Schneider said he was not a board-certified pain management expert. They also played a video of a meeting Linda Schneider had with the Drug Enforcement Administration that prosecutors contend showed she knew some patients were selling drugs and some had overdosed and died.

But defense attorneys got DEA agent Martin Redd to acknowledge that Linda Schneider reported during that interview that another doctor from her clinic, Dr. Lawrence Simons, was illegally prescribing drugs. The clinic fired Simons, and he was later convicted of illegally prescribing drugs in an unrelated case.