贵阳治疗前列腺肥大价格(贵阳治海绵状血管瘤的专业医院) (今日更新中)

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 0,000 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, according to an Associated Press analysis of federal data.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."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.Once, he met a woman in the parking lot of a Starbucks, she handed him 0 and he gave her a prescription for fentanyl, an opioid pain reliever that is 50 to 100 times more potent than morphine.When area pharmacists started refusing to fill prescriptions written by Smithers, he directed patients to far-flung pharmacies, including two in West Virginia. Prosecutors say Smithers also used some patients to distribute drugs to other patients. Four people were indicted in Kentucky on conspiracy charges.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.Even before he opened his Martinsville practice in August 2015, Smithers had raised suspicions. West Virginia authorities approached him in June 2015 about a complaint with his practice there, but when they returned the next day with a subpoena, they found his office cleaned out and a dumpster filled with shredded papers and untested urine samples.Some of Smithers' patients have remained fiercely loyal to him, insisting their severe chronic pain was eased by the powerful painkillers he prescribed.Lennie Hartshorn Jr., the father of the West Virginia woman who died two days after taking drugs Smithers prescribed, testified for the defense.Hartshorn said his daughter, Heather Hartshorn, told someone "she would rather be dead than in pain all the time." According to a form Heather Hartshorn filled out when she went to see Smithers, she had chronic pain in her lower back, legs, hips and neck from a severe car accident and a fall.When asked by Smithers' lawyer if he blames Smithers for anything, Lennie Hartshorn said he does not.Smithers has been denied bond while he awaits sentencing. His attorney did not respond to inquiries from AP. Smithers has said he plans to appeal.____Associated Press reporters Geoff Mulvihill and Riin Aljas contributed to this story. 6501

SACRAMENTO, Calif. (AP) — The California Supreme Court ruled unanimously Monday that inmates convicted of nonviolent sex crimes cannot be denied a chance at early parole consideration under a ballot measure approved by nearly two-thirds of voters four years ago.Former Gov. Jerry Brown, who championed the 2014 initiative as a way to reduce prison populations and costs by speeding chances for parole, has repeatedly said he and other proponents never intended for it to cover sex offenders.But lower appeals courts ruled that the plain language of the initiative means they cannot be excluded from consideration as nonviolent offenders, and the high court agreed. 672

SACRAMENTO, Calif. (AP/KGTV) — California Gov. Gavin Newsom on Friday signed a law that will make the state the first to allow employers, co-workers and teachers to seek gun violence restraining orders against other people.The bill was vetoed twice by former governor Jerry Brown, a Democrat, and goes beyond a measure that he signed allowing only law enforcement officers and immediate family members to ask judges to temporarily take away peoples' guns when they are deemed a danger to themselves or others.They were among 15 gun-related laws Newsom approved as the state strengthens what the Brady Campaign to Prevent Gun Violence calls the nation's toughest restrictions."California has outperformed the rest of the nation, because of our gun safety laws, in reducing the gun murder rate substantially compared to the national reduction," Newsom said as he signed the measures surrounded by state lawmakers. "No state does it as well or comprehensively as the state of California, and we still have a long way to go."Newsom also signed into law AB 893, which prohibits gun and ammunition sales at the Del Mar Fairgrounds. The bill was introduced by Assemblyman Todd Gloria in February. The ban is set to go into effect in 2021.Anyone who violates the law could face a misdemeanor charge, according to the bill. Before the law was signed, Gloria called the bill a "victory for gun sense and making our communities safer in San Diego."State Senate President pro Tempore Toni Atkins (D-San Diego) said the bill "offers tangible, real steps to keep all California residents safe."“I congratulate Assemblymember Todd Gloria for getting AB 893 signed into law by Governor Newsom today. AB 893 responds to our community’s desire to stop selling guns and ammunition on state property, specifically at the Del Mar Fairgrounds," Atkins said in a release. "This bill offers tangible, real steps to keep all California residents safe by closing off another pathway for criminals to move guns from the legal market to the unregulated one.”Gun shows have been hotly debated at the Del Mar Fairgrounds over the last year. In September 2018, the 22nd DAA's Board of Directors temporarily suspended the shows until safety policies were developed. The decision ended the Crossroads of the West gun show after nearly three decades.Friday, Michael Schwartz, executive director of the San Diego County Gun Owners political action committee, said the bill was discriminatory.“Banning a gun show on just one state owned property, but not on all is proof positive that this is discrimination based on political bias and has nothing to do with safety. We are opposed to discrimination against a group of law-abiding citizens who are simply practicing their civil rights," Schwartz wrote. 2774

SACRAMENTO, Calif. (AP) — California lawmakers on Tuesday advanced a bill that would let legislative leaders raise and spend more money to help their preferred candidates.Their vote came despite opposition from open-government groups who argued the bill would spur more pay-to-play politics at the Capitol.The bill would let leaders in the Legislature operate fundraising committees governed like state and county party committees. Such committees have higher contribution limits than regular campaigns and can give unlimited amounts to help state candidates.Senators voted 3-2 to advance the bill out of a committee.Lawmakers supporting the proposal argue it would help them combat the influence of independent expenditures. They also argue the bill would increase transparency by requiring more frequent disclosures by party and legislative leadership committees. 873

SACRAMENTO, Calif. (AP) -- California has surpassed 10,000 deaths from the coronavirus, making it the U.S. state with the third-highest number of deaths since the pandemic broke out earlier this year.The figure was reported Friday, with 10,024 dead since the coronavirus was detected in California in February.New York and New Jersey have the highest and second highest number of deaths in the U.S. at 32,000 and 16,000, respectively.The first known COVID-related death in the U.S. occurred in early February in the San Francisco Bay Area county of Santa Clara. 569

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