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HomeMedico-LegalUS opioid crisis: Doctor faces life in prison for over-prescribing

US opioid crisis: Doctor faces life in prison for over-prescribing

US physician Dr Joel 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, the best Smithers can hope for is a mandatory minimum of 20 years.

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. According to an AP report, 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 US Drug Enforcement Administration who oversaw the investigation into Smithers.

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.

The report says 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 report says the opioid crisis has been decades in the making and has been fuelled 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 US Centres for Disease Control and Prevention.

Andrew Kolodny, a Brandeis University doctor who has long been critical of opioids, said that in recent years, doctors became less comfortable writing lots of opioid prescriptions and many big prescribers retired. That opened an opportunity for others. “If you’re one of the guys still doing this,” he said, “you’re going to have tons of patients knocking down your door.”

The report says during his trial, Smithers testified that after he moved to Virginia, he found himself flooded with patients from other states who said many nearby pain clinics had been shut down. Smithers said he reluctantly began treating these patients, with the goal of weaning them off high doses of immediate-release drugs. He acknowledged during testimony that he sometimes wrote and mailed prescriptions for patients he had not examined but insisted that he had spoken to them over the phone.

At his trial, Smithers portrayed himself as a caring doctor who was deceived by some patients. “I learned several lessons the hard way about trusting people that I should not have trusted,” he said. Smithers’ lawyer told the judge he had been diagnosed with depression and anxiety. Family members said through a spokesperson that they believe his decisions were influenced by personal stress, and emotional and mental strain.

The report says some of Smithers’ patients have remained fiercely loyal to him, insisting their severe chronic pain was eased by the powerful painkillers he prescribed.

[link url="https://www.apnews.com/6d5448da554f4268b348fc3f597cb44a"]AP News report[/link]

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