RICHMOND, Va. — 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 $700,000 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 $300 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.
UPPER TRACT, W.Va. — The Rev. Jess Felici looked out from her pulpit at her tiny flock.
“Our closing hymn comes from our green books, Number 492,” she said. The pianist struck up the opening notes. And the pastor walked right down the aisle and out the church door, leaving her congregants still singing without her.
She turned on her car. Drove down the gravel road until she reached the paved one. Took the hairpin turns down into the valley and back up the next mountain.
Forty-one minutes later, she walked through the doors of her next church, where the service was well underway. Still wearing her white robes, she waited while a congregant finished reading from the book of Psalms, then took over the pulpit. “I invite you to stand as you are able for a reading of the Gospel,” she picked up seamlessly.
Two churches down and one more to go on this Sunday for Felici.
Jess, 36, and her husband, the Rev. Jason Felici, 33, serve together as the pastors of five churches in one of the most isolated pockets of America. Their weekly acrobatics of military-precision timing and long-distance driving are what it takes to make Sunday church services happen in a place where churchgoers are aging, pews are getting emptier and church budgets are getting smaller.
That makes Appalachia much like the rest of the country when it comes to mainline Protestant churches.
Mainline denominations — the historically indomitable Protestant institutions that were the backbone of early American respectability, including Methodist, Presbyterian and Lutheran churches — are now on a precipitous decline.
From 2007 to 2014, according to Pew Research, the number of mainline Protestants in the United States dropped by about 5 million people, leaving just 14 percent of Americans — about 36 million — identifying with any mainline denomination.
One in every five American adults were raised in a mainline church. But less than half of them continue to affiliate as adults.
That has left churches, especially in rural areas, facing the tough question of how to keep serving the members who remain. Some churches simply close. Others merge. And in an increasing number of places, rural and even urban, pastors are bringing back an old-fashioned concept: the circuit preacher.
“The circuit rider in a lot of ways was lost,” Jason Felici said. “This is, in some way, the model of the future.”
The Hartford Institute for Religion Research found in a survey of more than 4,000 churches that in 2010, 71 percent of churches had a full-time paid pastor. Five years later, 62 percent did.
The Felicis, who started dating while both were in seminary to become pastors in the Evangelical Lutheran Church in America (the ELCA, a liberal-leaning mainline church that is not an evangelical denomination, despite its name), have spent their careers facing these trends.
When they graduated seven years ago, they took up their call as the pastors not of one local Lutheran church, but five.
In these seven years, they have come to know individual deer by sight. They have become accustomed to a 100-year-old parishioner coating cotton balls in peppermint oil to get the smell out when the skunk gets under a church building. Their daughter, Emma, was born here, and they will welcome another child soon.
They have learned the signs of a church emptying out. There are the economic pressures — jobs lost in Pendleton and Pocahontas counties that have forced families to move to Virginia or Washington; shrinking farm profits that have pushed people out of full-time farming.
This isolated corner of Appalachia is simply a hard place to live. The drive from the nearest city, Harrisonburg, Va., is at least an hour — all the way up and down the steep mountain that separates this area from the outside world. Under decades-old law meant to preserve this area for scientific research, there’s no cellphone service or radio in most of the two counties, which are in the National Radio Quiet Zone. In certain parts, even at-home wireless Internet or microwave ovens are banned to protect the research zone.
And then there are the religious trends — Americans are growing ever more secular, with well over 20 percent now identifying with no religion at all. Conservative evangelical churches have shrunk, too, but not as rapidly as the mainline denominations, such as the Felicis’ Lutheran church, that hold more-liberal positions on issues such as homosexuality and the role of women.
“It’s secularization. I don’t know how else to say it. The product that we had is not working for a lot of people,” said Lewis Parks, a professor retired from Wesley Theological Seminary, a United Methodist training institute in the District. Parks traveled to small churches throughout the country, researching a book. “What’s happening now,” he said, “it’s the cutting edge of a lot of mainline denominations — how to cope with the loss of members. ... What’s our model?”
In the United Methodist Church, decisions can come from the top down, with denominational leaders deciding to shutter a church or have churches start sharing a pastor.
“Many laity feel their traditions and cultures are lost when two local churches merge into one,” said Bishop Kenneth H. Carter Jr., the president of the United Methodist Council of Bishops. Rather than mergers, therefore, bishops are turning more often to a circuit-preacher model. “The UMC has a history of circuits,” Carter said. “The practice of a pastor serving more than one church dates back more than two hundred years.”
In other denominations, the decisions are left to local churches. That is the case in the ELCA, the denomination of all five of the Felicis’ churches: Any church or collection of churches, of any size, can hire a pastor as long as the members can raise at least the set base salary.
Every Sunday, one of the Felicis starts the day at 7:15 a.m. with a 57-mile drive to the farthest of their churches, New Hope in Minnehaha Springs. After the service, that pastor drives all the way back to Franklin, where the Felicis live, to preach at the 11 a.m. service at the church next door to their parsonage. Meanwhile, the other pastor makes a mad dash through three church services, which means leaving early and arriving back late to get it all done. Each pastor writes one sermon each week and delivers it two or three times.
At Mount Hope in Upper Tract, some Sundays just eight people show up. “I just don’t want to be here when it ends,” Stanna Smith said about her diminishing congregation as she arrived at the church, less than a mile from her family’s chicken farm. She has been attending since her wedding 58 years ago. The church dates to the 1790s.
At St. John in Moyers, Judy Propst, suffering from congestive heart failure, got out of her wheelchair and into the pew with help from her daughter. Her oxygen quietly hissed and popped by her side. Her 96-year-old mother-in-law sat across the aisle, and her husband, who is battling cancer.
This church has been their family’s home for generations: outside, more than a dozen headstones in the graveyard say “Propst.” Now Judy worries about its future. “So many people with medical problems,” she said. “We don’t have so many people coming anymore.”
Already, these five churches are a result of consolidation. These valleys were home to Mount Zion, St. Michael and others — churches that West Virginia Lutherans still proudly proclaim as their home churches.
“There would be well over 100 people” at St. Michael on a Sunday, Beth Felton recalled as she tucked into the lunch after the service at Calvary Church in Brandywine. That church is gone, and the congregation left at Calvary is far smaller, but it is still proudly baking for the monthly potluck — chicken-noodle casserole and meatloaf, collard greens and tiny ham sandwiches, salad drenched in dressing and cheddar cheese.
The pastors and the congregants all know full well that these five churches will not last as they are. But no one is ready to talk about change yet.
“We have a significant number of people in their 90s and older who drive themselves. If they had to drive more than a mile and a half to get to their church, we wouldn’t see them anymore,” Jess said on one of the rare weekdays that she and Jason are at home together, instead of driving the long distances across their 75-mile-wide parish to visit sick or homebound members.
“Out here, the church is the last social organization left,” said Jason, who grew up in the more populous West Virginia city of Wheeling. “The local post office is closed. The local social hall is closed. The local general store is closed.”
“When you age out of the volunteer firefighters or EMT, the church is the one place you have contact with people socially,” said Jess, who grew up in the Harrisburg area.
Jason added, “People can name the parents, grandparents, great-grandparents who literally built the buildings with their own hands.”
The two pastors reflected at the parsonage, where they live on a ridge overlooking endless trees, where they know the one spruce where a young bald eagle lives. “It’s a beautiful thing,” Jason said.
Through clergy networks on social media, Jason and Jess hear from pastors across the country who are new to circuit preaching. Their fellow circuit riders seek advice about how to maintain relationships with parishioners despite the long distances and about how to offer robust ministries when manpower is limited.
Jason and Jess tell these pastors how, come Sunday, they drive from church to church to church, holding the same service five times for a couple dozen people in each simple white-walled sanctuary.
When Jason drives the longest leg of the circuit, an hour and 15 minutes to Minnehaha Springs, sometimes he doesn’t pass another car.
“As the raw numbers in our counties decline, it’s not about the numbers,” he said on a recent Sunday. “It’s about faithfulness. It’s about the mission. It’s about what we are called to be doing in this place.”
Jess drove, this Sunday, in the other direction, toward their very smallest church, Mount Hope. “The thought of closing this church is just so grief-laden,” she said as she drove up the hill, past the chicken barn she visits every year when the baby chicks hatch. “We all think about what it would be like if there weren’t enough people to have a congregation here. We put it off. Because it’s just painful to think about.”
She pictured this church on its best night, when it fills to the brim on Christmas Eve. The young people who have moved away to Morgantown and Washington are home. The families too busy and exhausted to attend church more than once a year are there. “Everybody’s spirits are glowing and the candles are lit and it’s dark outside,” she said. “I’m not sure I have the words for it.”
She was almost at the church, the first one of the day. She thought of that sacred night, and the sacred spaces she and Jason create every Sunday.
She pulled up in front of the graveyard, where the faithful generations who sustained this church for more than two centuries are resting. She looked up at the simple building where their descendants carry on into an uncertain future. She turned off the car and opened the door.
MILTON — Despite temperatures in the low 90s, fall was in the air in Milton as Cabell County residents enjoyed the mark of the start of the Pumpkin Festival Sunday afternoon via a parade.
The streets were lined Sunday as the parade started at Pumpkin Park before going eastbound down U.S. 60 before turning at Ohio Valley Bank and going through town along Smith, Mason and Pike streets, eventually returning to the park.
For Kathrine Lovejoy, of Cabell County, the parade is the first mark of the fall season, whether the temperature reflects that or not.
“This festival is happening. The pumpkins are here. The hay barrels are out,” she said. “Something has to give.”
Since 1986, the West Virginia Pumpkin Festival has turned into one of the state’s largest celebrations, celebrating fall and harvesting. The festival started as a way to help farmers with the raising and selling of pumpkins.
The parade is a way for Milton’s 2,400 residents to celebrate the fall season prior to about 50,000 outsiders making their annual migration to the Mud River 80-acre fall celebration.
Each year over 100 skilled artist display juried crafts, special exhibits and demonstrations, alongside musicians and food vendors who round out the festival.
The parade is just like any other – featuring candy, marching bands, antique cars, fire trucks and horses, with festival queens riding in cars and carriages along the way – but it means so much more than just a parade to the Milton residents.
Stacy Callis, of Milton, said she had been attending the festival and parade for decades.
“It kind of stays the same over the years. Browsing the booths can get a little redundant, but coming to the festival is like an annual reunion or something. I’ll see people I haven’t seen all year and get a chance to catch up. Moments like that are really what it means to me.”
Her toddler granddaughter declined to comment on her thoughts of the parade for fear of missing her chance to pick up some candy.
The Pumpkin Festival will be open from 9 a.m. to 9 p.m. Thursday-Saturday, Oct. 3-5, and from 9 a.m. to 6 p.m. Sunday, Ovzct. 6. Admission is $8 Thursday-Friday, Oct. 3-4, and $10 Saturday-Sunday, Oct. 5-6. Parking is free. Learn more at wvpumpkinpark.com.
HUNTINGTON — Two Huntington men were indicted by a grand jury this month after being accused of perpetrating two unrelated violent crimes in the city.
Thomas Paul Anderson, 54, of Huntington was indicted on one count of malicious wounding in a separate, unreleased case.
Anderson was arrest June 14 after police were called to the scene of a stabbing in the 2500 block of Marcum Terrace in Huntington. He is accused of stabbing Donald Accord, 50, twice during an altercation between the two individuals. Accord’s injuries appeared to be non-life-threatening at the time, police had said.
Ryan Lee Vannatter, of Huntington, was charged with nine counts of wanton endangerment surrounding a Sept. 18, 2018, shots fired incident along 3rd Avenue.
The investigation into Vannatter began after police were called to the 26th Street and 3rd Avenue area at approximately 6:14 p.m. Sept 18. Nine 9mm shell casings were located behind a residence in the 2500 block of 3rd Avenue. Witnesses told police and dispatchers they saw a burgundy sport utility vehicle leave the area after the shots were heard, and there were children playing in the area when the shots went off.
Police asked to see a resident’s home security footage and learned the vehicle in question was a burgundy Dodge Durango. The vehicle was located in 9 1/2 alley at the intersection of 21st Street, where the suspect fled inside a residence when he saw police. Vannatter was apprehended after police identified him as the suspect in the surveillance video.
A Cabell County grand jury also returned the following indictments in September. An indictment is a formal charge made against a person by a grand jury. It does not establish guilt or innocence.
Cameron G. Blue, Greensboro, North Carolina: Second-degree sexual assault and strangulation.
Christopher Lloyd Burns, 1100 block of 3rd Avenue: Receiving stolen automobile.
Ronald Tyler Burns, Barboursville: Possession with intent to deliver a controlled substance and conspiracy.
William Cody Coleman, Milton: Reckless driving, fleeing in a vehicle with reckless indifference and no operator’s.
Amanda Louise Daniels, 100 block of North High Street, Huntington: Obtaining money by false pretenses, conspiracy and third-offense shoplifting.
Daniel Merle Dykes, 3500 block of 5th Avenue, Huntington: Receiving stolen automobile, fleeing in a vehicle with reckless indifference and fleeing in a vehicle.
Marsha Earle, 200 block of Short Street Rear, Huntington: Burglary and petit larceny.
Jason M. Flowers, 5100 block of Altizer Avenue, Huntington: Entry of a building other than a dwelling, grand larceny and conspiracy.
Jermaine Maurice Johnson, 1200 block of 26th Street, Huntington: Strangulation and domestic battery.
Scotty Andrew Jones, 1300 block of Jefferson Avenue: Domestic battery, strangulation and domestic assault.
William Richard Legge, 300 block of 25th Street, Huntington: Malicious wounding.
Ryan Tyler Massie, Ironton, Ohio: Embezzlement.
Harold J. McCormick, Gallipolis, Ohio: Obtaining money by false pretenses.
Stephen Dale Meadows, Lesage: Failure to register as a sex offender, driving on a suspended or revoked license for miscellaneous reasons, no registration and no insurance.
Trista Renae Shelton, 6900 block of Merritts Creek Road: Fraudulent use of an access device.
Jeremiah Howard Stepp, 300 block of Rear Tierman Street, Huntington: Destruction of property and domestic assault.
Brittany Ann Stowers, Ranger, West Virginia: Possession with intent to deliver a controlled substance and conspiracy.
Jeffrey Lee Sutton, Barboursville: Attempt to commit a felony.
Kayla Shablee Thacker, 1700 block of Jefferson Avenue, Huntington: Third-offense shoplifting and obstructing an officer.
Joe Walden II, 100 block of 4th Avenue, Huntington: Possession with intent to deliver a controlled substance.
Tommy R. Workman Jr., Red House, West Virginia: Malicious assault on a correctional employee.