Doctor faces life in prison for thousands of opioid doses

RICHMOND, Va. (AP) — By the time drug enforcement agents swooped into his small medical office in Martinsville, Virginia, in 2017, Dr. Joel Smithers had prescribed about a half a million doses of highly addictive opioids in two years.

Patients from five states drove hundreds of miles to see him, spending up to 16 hours on the road to get prescriptions for oxycodone and other powerful painkillers.

“He’s done great damage and contributed ... to the overall problem in the heartland of the opioid crisis,” said Christopher Dziedzic, a supervisory special agent for the Drug Enforcement Administration who oversaw the investigation into Smithers.

In the past two decades, opioids have killed about 400,000 Americans, ripped families apart and left communities – many in Appalachia – grappling with ballooning costs of social services like law enforcement, foster care and drug rehab.

Smithers, a 36-year-old married father of five, is facing the possibility of life in prison after being convicted in May of more than 800 counts of illegally prescribing drugs, including the oxycodone and oxymorphone that caused the death of a West Virginia woman. When he is sentenced Wednesday, the best Smithers can hope for is a mandatory minimum of 20 years.

Authorities say that, instead of running a legitimate medical practice, Smithers headed an interstate drug distribution ring that contributed to the opioid abuse epidemic in West Virginia, Kentucky, Ohio, Tennessee and Virginia.

In court filings and at trial, they described an office that lacked basic medical supplies, a receptionist who lived out of a back room during the work week, and patients who slept outside and urinated in the parking lot.

At trial, one woman who described herself as an addict compared Smithers’ practice to pill mills she frequented in Florida.

“I went and got medication without – I mean, without any kind of physical exam or bringing medical records, anything like that,” the woman testified.

A receptionist testified that patients would wait up to 12 hours to see Smithers, who sometimes kept his office open past midnight. Smithers did not accept insurance and took in close to $700,000 in cash and credit card payments over two years.

“People only went there for one reason, and that was just to get pain medication that they (could) abuse themselves or sell it for profit,” Dziedzic said.

The opioid crisis has been decades in the making and has been fueled by a mix of prescription and street drugs.

From 2000 to 2010, annual deaths linked to prescription opioids increased nearly fourfold. By the 2010s, with more crackdowns on pill mills and more restrictive guidelines on prescriptions, the number of prescriptions declined. Then people with addictions turned to even deadlier opioids. But the number of deaths tied to prescription opioids didn’t begin to decline until last year, according to data from the U.S. Centers for Disease Control and Prevention.

Martinsville, where Smithers set up shop, has been particularly hard hit.

A city of about 14,000 near Virginia’s southern border, Martinsville once was a thriving furniture and textile manufacturing center that billed itself as the “Sweatshirt Capital of the World.” But when factories began closing in the 1990s, thousands of jobs were lost. Between 2006 and 2012, the city had the nation’s third-highest number of opioid pills received per capita.