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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

RICHMOND, Indiana — An emergency call credited with foiling the shooting at a Richmond middle school on Thursday was made by the teenage suspect's mother, according to multiple sources with knowledge of the investigation.The call was made at 8:11 a.m. local time by the mother, according to information obtained from Wayne County's Emergency Communications Division.Sources tell WRTV television station in Indianapolis the mother called after the teenage boy had taken another family member hostage and forced them to drive to Dennis Intermediate School, just a little more than a mile from their home.Once the boy was at the school, he entered the building through a side door and eventually exchanged gunfire with responding officers, before turning the gun on himself, according to the sources.WRTV did request a recording of the call made to Wayne County's Emergency Communications Division, but the call is not being released due to the investigation.The advance call gave the school valuable minutes to lock down the middle school and allow police to quickly respond to the school, sources said. 1119

SACRAMENTO, Calif. -- Legislation was announced Thursday to raise the purchasing age of long guns such as rifles and shotguns from 18 to 21 in California.The legislation was introduced by Assemblymember Rob Bonta, a Democrat from Oakland.Assembly Bill 3 would mirror existing laws for purchasing handguns which state that a person must be at least 21-years-old to purchase a handgun.“California already wisely mandates that someone be at least 21 years of age to purchase a handgun,” said Assemblymember Bonta. “It’s time to extend that common-sense law to long guns in order to enhance public safety.”"We must take every reasonable measure to protect Californians from gun violence," said Assemblymember David Chiu (D-San Francisco), Joint Author of the bill.According to a 2015 report by the FBI, adults 18 to 20 represent four percent of the population but commit 17 percent of gun homicides.“Californians under age 21 can’t purchase alcohol, tobacco and other health hazardous items,” said Senator Nancy Skinner (D-Berkeley), Principal Co-Author of AB 3. ”So why should they be able to buy guns? Our bill fixes that.” 1134

SACRAMENTO, Calif. (AP) — Two major law enforcement organizations have dropped their opposition to California legislation that strengthens standards for when officers can use of deadly force, a shift that comes after supporters made changes to the measure.Spokesmen for organizations representing California police chiefs and rank-and-file officers told The Associated Press on Thursday that they won't fight the measure, which was prompted by public outrage over fatal police shootings.As originally written, the measure would bar police from using lethal force unless it is "necessary" to defend against an imminent threat of death or serious bodily injury to officers or bystanders.That's a change from the current standard, which lets officers kill if they have "reasonable" fear they or others are in imminent danger. The threshold made it rare for officers to be charged following a shooting and rarer still for them to be convicted."With so many unnecessary deaths, I think everyone agrees that we need to change how deadly force is used in California," said Democratic Assemblywoman Shirley Weber of San Diego, who wrote the measure. "We can now move a policy forward that will save lives and change the culture of policing in California."Law enforcement officials did not immediately explain their decision. But a revised version of the bill filed Thursday drops an explicit definition of "necessary" that was in the original version. The deleted language provided that officers could act when there is "no reasonable alternative."The amended measure also makes it clear that officers are not required to retreat or back down in the face of a suspect's resistance and officers don't lose their right to self-defense if they use "objectively reasonable force."Amendments also strip out a specific requirement that officers try to de-escalate confrontations before using deadly force but allows the courts to consider officers' actions leading up to fatal shootings, said Peter Bibring, police practices director for the American Civil Liberties Union of California, which proposed the bill and negotiated the changes."By requiring that officers use force only when necessary and examining their conduct leading up to use of force, the courts can still consider whether officers needlessly escalated a situation or failed to use de-escalation tactics that could have avoided a shooting," he said.Even with the changes, the ACLU considers the bill to have the strongest language of any in the country.Democratic leaders in the Legislature signed on to the revised version, which is set for a key Assembly vote next week. 2634

RIP Hugh Keays-Byrne ?? It’s amazing you were able to play an evil warlord so well cause you were such a kind, beautiful soul. You will be deeply missed my friend. pic.twitter.com/kXDhNs5jEU— Charlize Theron (@CharlizeAfrica) December 2, 2020 250