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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

SACRAMENTO, Calif. (AP) — A rookie Sacramento police officer who died during a domestic violence call was ambushed by a gunman and had no chance of surviving after she was shot, police said.The disclosure came late Friday amid criticism that it took police 45 minutes to get to 26-year-old rookie Officer Tara O'Sullivan during the armed standoff.O'Sullivan was later pronounced dead at a hospital.O'Sullivan was hit several times and one of the wounds was "non-survivable," Sgt. Vance Chandler said at a news conference where the department released police body camera video of the Wednesday night attack.Police Chief Daniel Hahn said the gunman had stashed two assault rifles , a shotgun and handgun in different rooms and opened fire as officers knocked on the door."The officers were essentially ambushed," Hahn said.He said patrol car doors and protective vests couldn't stop the high-powered rifle rounds, and if officers had tried to rescue their fallen colleague before an armored vehicle arrived, "we would have additional officers murdered.""Under the most dangerous and trying circumstances, our officers performed admirably," the chief said.Earlier in the day, suspect Adel Sambrano Ramos, 45, was charged with murder, attempted murder and possessing two illegal assault rifles.O'Sullivan was standing behind her training officer, Daniel Chip, when she was struck, police said.Footage from Chip's body camera showed him approaching a detached garage with his gun drawn, knocking and calling out: "Hey, Adel, Police Department... You're not under arrest, you're not in trouble."The officer then opens a screen door and begins to cautiously enter the open doorway, asking Adel if he is inside and repeating: "You're not in trouble, dude."At that moment, more than 20 rapid shots are heard. The officer runs for cover and radios that a high-powered rifle is being fired."Officer down! Officer down!" he says.Police said the gunman had opened fire from a house behind the officers and barricaded the front door.The charges against Ramos carry special circumstances, including that he killed O'Sullivan while lying in wait, an allegation that would allow authorities to seek the death penalty. However, that decision is months away and Gov. Gavin Newsom has imposed a moratorium on executions.Ramos is set to appear Monday for his first court appearance. Public defender Norm Dawson said he couldn't comment until he receives more details in the case.Police said the gunman strategically shot at officers for hours, using all the weapons kept in different rooms. He surrendered after an eight-hour standoff.Nine days before the officer's killing, a judge issued a warrant for the arrest of Ramos for failing to appear on a charge of battering a young woman.Police said the gunman opened fire as O'Sullivan and other officers helped an unidentified woman clear out her belongings from the garage of a North Sacramento home.Police earlier found two guns in a neighboring home associated with Ramos and learned about the warrant in the battery case. Five officers went to find him before the ambush occurred, police said.Authorities said lower-level warrants like the one Ramos faced rarely lead police to actively seek an arrest."I cannot tell you even in my (30-year) career where we had a misdemeanor bench warrant and we went out looking for somebody. That's just not practical," California Police Chiefs Association President Ronald Lawrence said. "Clearly you had a person who had a propensity for violence and wasn't held accountable for earlier crimes."Ramos has a history of domestic violence restraining orders, but most recently was charged in November with simple battery against a minor woman in September.Defense attorney and former prosecutor William Portanova, who is not associated with the case, said simple battery "means a slap or a push or a shove, but there's no bruises or stitches or bleeding and nothing is broken."Ramos failed to appear in February and a bench warrant was issued then withdrawn when he resurfaced. Another was issued June 10 and was active when O'Sullivan was shot.Sacramento County Sheriff's Department spokeswoman Sgt. Tess Deterding said many times deputies won't arrest lower-level fugitives even if they discover an outstanding warrant, because the offender would simply be released again with a new order to appear in court."I think it largely depends on the scenario at the time. Is this a person that needs to go to jail right now? Is this a solution to the problem that I have?" she said.Portanova said it's a reality of understaffed police agencies that so many warrants remain outstanding."Citizens are paying the price," he said. 4696

SACRAMENTO (AP) — California would set a goal of generating 100 percent of the state's energy from carbon-free sources under legislation approved by the state Assembly.The bill approved Tuesday would accelerate California's renewable energy mandate from 50 percent to 60 percent by 2030. It would then set a goal of phasing out all fossil fuels by 2045, but it does not include a mandate or penalty.Supporters say the measure would help address climate change and boost California's clean energy economy.RELATED: California Energy Commission approves solar panel requirement for new homesCritics say it's unrealistic and would saddle families and businesses with higher energy bills.The measure returns to the Senate which must approve changes made in the Assembly. It was written by Democratic Sen. Kevin de Leon, who is challenging fellow Democratic U.S. Sen. Dianne Feinstein. 892

SACRAMENTO, Calif. (AP) — The California Senate will investigate a California utility's process for cutting off power to more than 2 million people to prevent wildfires.In a memo to the Senate Democratic Caucus on Thursday, Senate President Pro Tempore Toni Atkins asked the Senate Energy, Utilities, and Communications Committee to "begin investigating and reviewing options to address the serious deficiencies" with PG&E's current process of shutting off power to prevent wildfires.Atkins said an oversight hearing will be scheduled in the next few weeks.Last week, dry conditions and dangerous winds prompted PG&E to cut power to more than 700,000 customers to prevent its equipment from sparking wildfires.Gov. Gavin Newsom and other leaders said the outage lasted too long. Newsom has urged the utility to give rebates to affected customers and businesses. 877

SACRAMENTO, Calif. (AP) — California will ban the sale and manufacture of new fur products starting in 2023.Legislation signed Saturday by Gov. Gavin Newsom makes California the first state to enact such a ban.It doesn't apply to used fur products or fur used for religious or tribal purposes. And it excludes the sale of leather, cowhides, deer, sheep and goat skin and anything preserved through taxidermy.There's a fine of up to ,000 for multiple violations.Democratic Assemblywoman Laura Friedman, the bill's author, says there are "sustainable and humane" substitutes for fur.Opponents of the legislation have said it could create a black market and be a slippery slope to bans on other products. 711