Joel Smithers, a 36-year-old married father of five, was arrested in 2017 at his practice in southern Virginia.
He was 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, and could face life behind bars at his Oct. 2 sentencing,
He has a mandatory minimum sentence of 20 years in prison.
Smithers is accused of contributing to the widespread opioid epidemic which has killed about 400,000 Americans over the last two decades.
Authorities say that, instead of running a legitimate medical practice in Martinsville, Virginia, Smithers headed an interstate drug distribution ring that contributed to the opioid abuse epidemic in West Virginia, Kentucky, Ohio, Tennessee, and Virginia.
Over a period of two years, Smithers made more than $700,000 from his patients who were either vulnerable and used the drugs to “abuse themselves,” or wanted to sell the pain medication for profit, said Christopher Dziedzic, a supervisory special agent for the Drug Enforcement Administration who oversaw the investigation into Smithers.
“He’s done great damage and contributed … to the overall problem in the heartland of the opioid crisis,” Dziedzic said.
According to court papers, Smithers’s practice had insufficient medical supplies, his receptionist would sleep in a back room throughout the week, and it smelled of urine just outside the building. Some patients would often sleep in the parking lot outside, court filings on the case stated.
Patients from across five states visited Smithers in his practice with some driving up to 16 hours to visit the clinic which would often stay open past midnight. Some waited an additional 12 hours upon arrival to see Smithers, according to the receptionist.
At a court hearing, one woman who referred to herself as an addict said Smithers’s clinic was like pill mills she had visited 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.
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.
Between 2006 and 2012, Martinsville—where Smithers set up his practice—received the third most opioid pills per capita out of all cities in the United States, according to an Associated Press analysis of federal data.
At his trial, Smithers said that he reluctantly treated many patients who he said told him many nearby pain clinics had been shut down. He said he began to treat those patients, with the goal of weaning them off high doses of immediate-release drugs.
He admitted to prescribing the drugs for patients without examination, 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.
The 36-year-old’s defense lawyer told the judge he had been diagnosed with depression and anxiety, while family members said they believe personal stress, and emotional and mental strain played a role in his actions.
Smithers has been denied bond while he awaits sentencing and he has said he plans to appeal.
The Associated Press contributed to this report.