The Candy Man Always Has Customers

So another candy man was busted and convicted in the ongoing fight to end the opioid “CRISIS.”  Dr. Joel Smithers ran The Center for Integrative Health at Smithers Community Healthcare, where they apparently integrated a lot of narcotics into a lot of repeat business.  Smithers was arrested and arraigned in August 2017, and released on a $25,000 bail.  This past May he was found guilty of “861 federal drugs charges, including that his prescriptions caused the death of a woman in West Virginia.”

Just an aside, but the timeline – along with the charges – seems like an amazing statement of hubris.  “Evidence presented at trial showed Smithers prescribed controlled substances to every patient in his practice, resulting in more than 500,000 Schedule II controlled substances being distributed.”  Every patient??

These charges don’t typically fall out of the blue.  There were likely multiple warnings that the feds were poking for evidence linking how some presumably fat coin was generated off flinging narcotics all over town.  “A majority of those receiving prescriptions from Smithers traveled hundreds of miles, one-way, to receive the drugs, court documents said. Smithers did not accept insurance and had taken in more than $700,000 in cash and credit card payments before a search warrant being executed at his office on March 7, 2017.”

How did this cat not already have an offshore account, a trouble bag, and a passport ready to go?  I’m deadly serious about this – do we believe that anyone making money as a candy man has such high ethics that he would want to stay and defend his reputation?  “At the time of that search warrant, statistics showed that, in the city of Martinsville, more opioid painkillers were being given out as prescriptions per person than anywhere else in the United States.”

In the age of linked state databases and a zealous, media-fueled DEA, if this is not hubris, it is at least a terminal lack of insight.

And speaking of terminal:  “The jury also found that the oxycodone and oxymorphone Smithers prescribed to a woman from West Virginia caused her death.”  Sentencing is scheduled for next month, and ex-Doc Smithers is looking at twenty-to-life. 

There isn’t a thing nice or good to say about this louse, and he deserves what is coming to him.  Yet how many patients, or enabling family members were held accountable in this case?  Did the feds track down the recipients of the goodies and charge them?  How many of the 861 charges involved an unindicted co-conspirator?  Did the West Virginia woman have any responsibility for her own death?  How many decent, honest physicians in the area will prescribe a little less, and keep their heads down, just in case?  I despise abusive doctors like this, just as I also despise the ongoing societal implication that jerks like this act alone.  

Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption.

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1 Response

  1. Jesse Lee Belville,PA-C says:

    Does anyone remember the 1990’s when PAIN became the 5th( fifth) vital sign. When medicare and medicaid based their reimbursement on answering that question. When hospitals and medical groups were rated on their services and quality of care based on answering that question!!!
    Does anyone remember the “Studies” stating that the incidence of addiction was very low in those who used long term opiods for pain.?
    No long term memory? All politics!? Many changes in work life for many people. many people do wake up every day and chose to continue drug use.
    Many physicians, NPs, and PA’s write scripts from ER’s, Urgent Care, IM clinics, FP clinics, chronic pain clinics. What are the criteria that lead to that, what is the Standard of Care. Are you meeting that? If chronic pain clinic, do you have clear guidelines for your patient, regular checks of that patient, random drug screens and a signed agreement between the patient and your practice with clear rules. I did that as a PA-C in 1999 working a chronic pain clinic. If you do all this and document well you will not have any difficulty caring for a chronic pain patient who is on chronic opioid therapy.
    Anyone who does not do all this under current guidelines is wrong. With all this every time you write for Any Drug, there is Always a risk. Aspirin, tylenol, Augmentin, keflex, codeine, oxycodone,atenolol, lorazapam. All can be beneficial in proper cicrcumstances. All carry risk. Small risk but still there. Much blame to go around.

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