As It Happens

'The red flags were all there': DEA agent busts doctor who ran opioid 'pill mill'

A Virginia-based doctor was sentenced to 40 years in prison for illegally prescribing opioids — and the special agent who led the investigation says it's a warning to others.

Dr. Joel Smithers was convicted in May of more than 800 counts of illegally distributing opioids

Dr. Joel Smithers was sentenced to 40 years in prison on Wednesday, Oct. 3, 2019 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. (Southwest Virginia Regional Jail Authority/Associated Press)

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A Virginia-based doctor was sentenced on Wednesday to 40 years in prison for illegally prescribing opioids — and the special agent who led the investigation says it's a warning to others.

Dr. Joel Smithers was convicted in May of more than 800 counts of illegally distributing opioids. The drugs caused the death of a West Virginia woman.

Authorities say Smithers prescribed hundreds of thousands of doses to patients from Virginia, Kentucky, West Virginia, Ohio and Tennessee from 2015 to 2017.

As It Happens reached out to Smithers's lawyer for comment, but have not received a response.

Christopher Dziedzic, supervisory special agent with the U.S. Drug Enforcement Administration (DEA), oversaw the investigation.

He spoke with As It Happens guest host Nil Köksal. Here is part of their conversation.

Mr. Dziezik, you've worked at the DEA for years. I've heard you describe this case as the worst case you've ever worked on.

I would stack it right up there as one of the worst ones —most blatant, yes.

What makes it that way?

It's just in the manner that the doctor ran his clinic. It was so obvious. I mean, the red flags were all there. There was no medical supplies whatsoever at the clinic. There was not even basic needs, such as soap.

One of the employees slept in the office. There was, I think, one medical exam bed. There was only one in the whole office.

Senior forensic chemist Emily Lockhart holds a bottle containing illicit 30 M Oxycodon at the Drug Enforcement Administration's Special Testing and Research Laboratory in Sterling, Va., on Feb. 19, 2019. (Jack Gruber/USA Today/Associated Press)

There were people loitering around, in and around the parking lot. They would arrive at all crazy hours of the day and night waiting to be seen.

Often the doctor would not actually be present, but he would have other workers issue prescriptions that he had left pre-signed. I mean, classic case of a pill mill.

This doctor, Joel Smithers, opened his office in Martinsville, Va., in August 2015. By the time he was arrested in 2017, how many prescriptions for opioids did he give to patients, and what kind of drugs are we talking about?

So in our calculation, we estimate it to be somewhere around half a million of Schedule 2s. So there was actually more than that. But these are the most severe, most restricted drugs such as oxycodone, oxymorphone.

Two years, though, is not a short amount of time. So why did it take so long, if it was so obvious?

Well, you know, by the time we got word of his clinic [it was] probably somewhere around September. We started the case in October. It takes a long time to investigate these clinics because of what's involved — the different investigative techniques that we take against them.

If you decide to go down this road, the DEA will go after you. We will investigate you and we will prosecute to the fullest.- Christopher Dziedzic

And you know, [when] you have an undercover [investigation] going on, you're going to be seen only once a month. So it's not like you can just go in ... and go back the next day. They do follow [the rule] where they only see the patient once every 30 days and issue a new set of prescriptions.

What do you think Dr. Smithers's motivation was here?

Money. Based on what I've seen, based on what we've uncovered, I cannot come up with any other reason than it was money. And he made good money. Each patient paid about three hundred dollars to be seen each time. So it was definitely worth it for him. And I believe we added up somewhere around $700,000 [US] where he had earned in the two-year span.

Used drug paraphernalia is seen after a search of a woman who was acting under the influence of heroine on April 19, 2017 in Huntington, West Virginia. Huntington, the city in the southwest corner of West Virginia, bordering Kentucky, has been portrayed as the epicentre of the opioid crisis in the U.S. (Brendan Smialowski/AFP/Getty Images)

He said in his testimony that he was duped by some of his patients. I'll read you a quote: "I learned several lessons the hard way about trusting people I should not have trusted." What's your response to that?

Well, my response is that he's the doctor. He's the educated one that should know. Of course, anyone can come in and say, "Hey, I'm in pain." "OK, well then here you go." Everybody was getting oxycodone or Schedule 2 prescriptions. There were no treatment plans. There was no referral to some specialists. So take it for what it's worth, but, you know, to me it's a lame excuse.

What message do you think or hope that this 40-year prison sentence will send to others prescribing opioids?

Well, first and foremost, I hope that [if] there are other doctors of similar interests, of sort of swaying away from their professional oath, I guess, that they think twice. [Or] pharmacists that don't … stop these people and they don't look at the dollar sign of someone coming in with a suspicious prescription.

So I hope it sends a message that: You know what? If you decide to go down this road, the DEA — these tactical diversion squads which I am part of — we will go after you. We will investigate you and we will prosecute to the fullest.


Written by Jonathan Ore with files from The Associated Press. Produced by Katei Geleff. Q&A edited for length and clarity.