A Louisiana businessman used a web of pain clinics, troubled doctors and runners to funnel methadone and oxycodone into eastern Kentucky — an area where prescription drug abuse is rampant, a federal prosecutor said Monday in opening statements at the clinic owner’s trial.

Assistant U.S. Attorney Roger West said Urgent Care Inc., owner Michael Leman of Metairie cared only about how much money he could make from running “pill mills” and selling drugs to patients who did not need them for medical reasons.

“Mr. Leman was very interested in how much money was to be made,” West told 10 women and four men on the jury. “It was all the bottom dollar.”

Defense attorney Rick Simmons described Leman as an aggressive businessman but told jurors in Lexington his client was not the cause of the problems at the urgent care clinics. Simmons said the doctors were overprescribing drugs on their own and staff members were making side deals with patients.

“He’s not a doctor,” Simmons said. “The problems in these cases are caused by the doctors.”

A federal grand jury in Lexington charged Leman with conspiring with two doctors, a clinic CEO and another clinic employee to distribute methadone and oxycodone to people in eastern Kentucky, particularly Pike and Floyd counties from 2004 through 2008. The two doctors pleaded guilty and served four years in prison. The CEO and a clinic nurse are awaiting sentencing.

Leman, 46, is charged along with two of his companies, Urgent Care Services of Philadelphia and Urgent Care Services of Cincinnati, with conspiracy to distribute controlled substances and conspiracy to launder funds. A criminal complaint and indictment charge Leman and the clinics with using runners from eastern Kentucky to travel to Louisiana, Pennsylvania and Ohio, pick up prescriptions of methadone and oxycodone, and return to Pike and Floyd counties to sell the drugs.

The trial is expected to last three to four weeks.

The case built on one brought by prosecutors five years ago against a doctor, nurse and multiple others who were charged with distributing the prescription pills in eastern Kentucky, where abuse of prescription medication has reached epidemic levels.

West said Leman intentionally hired doctors with legal problems to staff the clinics, including Stanley Naramore, who the prosecutor described as “completely incompetent, yet he was trusted to write prescriptions for Kentucky patients.”

Naramore lost his medical license in Kansas after being convicted of overdosing a terminal patient. That conviction was overturned. Naramore served four years in federal prison for his role in the pain pill scheme.

The scheme worked by having “sponsors” round up people to go to the clinics in Louisiana, Cincinnati and Philadelphia to get prescriptions for 40 mg wafers of methadone and oxycodone pills, West said. The patients would get fake MRIs to take to the clinics, which had little medical equipment, West said. For his work, the sponsor would get half of the prescribed pills, while the patient would sell the rest for as much as $50 per dose, West said.

West acknowledged that many prosecution witnesses have reached plea agreements and have alcohol, drug or financial problems, but said the chain would lead to Leman at the top of the scheme.

“Mr. Leman knew what was going on and he chose to ignore it,” West said.

The defense attorney said many of the witnesses reached deals with prosecutors to avoid or lessen jail time and will implicate Leman as part of those deals.

Simmons said the patients at the clinics lied to the staff, who in turn lied to the doctors. As far as the clinic management knew, drug hunters and doctor shoppers were being turned away, Simmons said.

“It occurred without the knowledge of my client,” Simmons said.

Simmons said Leman has successful clinics in Slidell, La., Metairie, La., Baton Rouge, La., and Lafayette, La., and didn’t know the staffs in Cincinnati and Philadelphia were cutting illicit deals with patients.

“That’s the issue, the key: knowledge,” Simmons said.