A Virginia doctor was sentenced this week to more than 40 years in prison after being found guilty of 861 federal drug charges at the end of a trial in Abingdon, Virginia, in May.

And as Joel Smithers, 36, prepares to serve his sentence, the cases against members of the drug trafficking organization he allegedly fueled, and which flooded Pike County with prescription opiates, are beginning to conclude as well.

Smithers was sentenced Wednesday by U.S. District Judge James P. Jones to serve a total of 480 months in prison for the charges which included maintaining a place for the purpose of illegally distributing controlled substance, possession of with the intent to distribute controlled substance and 859 individual charges of illegally prescribing Schedule II controlled substances. According to a statement from the office of U.S. Attorney for the Western District of Virginia Thomas T. Cullen, at Smithers’ trial in May, the jury found that the oxycodone and oxymorphone Smithers prescribed to a woman from West Virginia caused her death.

With Smithers’ sentencing, open cases only remain against two defendants, the alleged ringleader of the conspiracy and a West Virginia pharmacist who was convicted of helping to provide the pills.

The alleged leader of the pill pipeline, Darryl K. Williams, 56, of Mullen Fork, Stone, and Buffalo, West Virginia-based pharmacist Jackson Noel, have both been convicted — Williams through a plea and Noel at trial.

Williams was set to be sentenced Friday, but the results of that hearing were not available as of presstime Friday. Noel’s sentencing is set for December.

Filings in the case, including testimony transcripts and other documents, reveal how the drug trafficking organization led by Williams’ capitalization on the opioid epidemic and made possible by Smithers’ prescribing practices was able to successfully operate and bring thousands of doses of the drugs into the area.

Anatomy of a pipeline

The drug trafficking organization led by Williams, filings and testimony show, utilized numerous individuals traveling to various states to receive and fill prescriptions for opioids, but much of the allegations center around the organization’s relationship with Smithers between 2015 and 2016.

Three others who allegedly served as “patients” in the conspiracy have already been convicted and sentenced in the case. Those defendants were:

• Lora M. Kicklighter, 44, of Belva, West Virginia, who was sentenced to more than four years in prison.

• Michael Robinette, 53, of Runyon Branch, Pinsonfork, who was sentenced to two years in prison.

• Michael Bowe, 66, of Bowling Fork, Stone, who was sentenced to a year in prison.

After beginning her sentence, Kicklighter was called in May to testify on behalf of the prosecution in Smithers’ trial in U.S. District Court in Abingdon, Virginia.

Her role, she said, began with her addiction.

“I participated in going to a doctor that — for starters, the reason I went is because I knew, you know, you could get strong medication without having an MRI or any of that stuff. It’s kind of like the way they did in Florida a few years back with what we call the pill mills,” Kicklighter testified. “I went and got medication without — I mean, without any kind of physical exam or bringing medical records, anything like that, and got a prescription for pain pills. I’m an addict, so that’s why I went, because I knew I could get opiates.”

Kicklighter testified that there were “probably more than 20 people” going to Smithers for prescriptions at the time of the conspiracy.

“Everybody that I met and knew pretty much in that area was going,” she said.

Kicklighter, who was Darryl Williams’ girlfriend at the time of the conspiracy, said Williams told her Smithers was a “good doctor.”

“You know, all we have to do is pay the money, he’ll write good scripts,” she said.

Kicklighter testified that she first saw Smithers at an office in Beaver, West Virginia, and talked with him, specifically requesting the pain medication, Opana. However, she testified, Smithers told her he could only write her a prescription for Roxicodone, and then “when we had a better-established relationship, he could write me the Opanas.”

Kicklighter, who testified she has been abusing opiates since 2003 and has participated in obtaining pills from several “pill mills,” said she didn’t take any medical records or MRI records with her to the appointment because she was told she wouldn’t need it.

“When you’ve been to different pill mills and stuff, you could just tell how it was,” she said. “So it was easy to get a prescription.”

Her next appointment with Smithers, she testified, was in his office at Martinsville, Virginia, at which time he wrote her a prescription for both Roxicodone and Opana. She testified that she sometimes had trouble filling Smithers’ prescriptions and that Smithers would text the members of the organization different pharmacies to which he recommended they go.

Kicklighter testified that the members of the conspiracy who were getting the prescriptions would bring them back to Williams, who would send another member to the pharmacy and get them all filled. That person would bring back the pills and Williams would take half of them to sell and give half back to the person for whom the prescription was written.

By July, Kicklighter’s testimony indicated, both she and Williams had been “discharged” from being patients at Smithers’ practice. Kicklighter, the testimony showed, was kicked out for testing positive for cocaine and Williams, she said, was kicked out for also testing positive for drugs he wasn’t supposed to be using.

However, prosecutors played a recording of a call Kicklighter made under the direction of the U.S. Drug Enforcement Administration a few weeks later during which she and Williams were able to work out paying Smithers $1,200 for five patients to get prescriptions from him, just as she alleged the operation had worked since before she and Williams were dismissed as Smithers’ patients.

Also, she testified, after she and Williams were discharged as patients, that Williams and Smithers continued to have friendly conversations.

“Darryl was actually trying to help Dr. Smithers, I think, come up with an investor for — to try to put in a pharmacy,” she testified. “Business went on as usual, even though we weren’t going.”

Buffalo Drug pharmacist involvement leads to conviction

Kicklighter’s testimony regarding the difficulty in finding pharmacies led her to discuss Buffalo Drug, located in Buffalo, West Virginia, which she said was one of the pharmacies to which she was directed.

Finding a pharmacy, she testified, was part of the pipeline process.

“When you find a pharmacy that, you know, they want cash, then you know that’s a pharmacy that’ll fill without questioning,” she said.

Kicklighter’s testimony indicated that the members of the conspiracy were traveling to several different pharmacies to fill prescriptions — in Chattanooga, Tennessee, Buffalo, West Virginia, Jeffersonville, Indiana and Richmond, Virginia — and that she was also receiving prescriptions from a doctor in Carthage, Tennessee.

Included in those pharmacies, she testified, was Buffalo Drug, which was under the direction of pharmacist Jackson Noel.

During Smithers’ trial, Kicklighter testified that filling prescriptions at Buffalo Drug was a little different.

“Buffalo, if you’d come in with a prescription for 90 Opanas, he would only give you 60 of them, but they would charge you the $1,400 for 90 of them,” she said.

Noel faces up to 20 years in prison after he was convicted earlier this month on a charge of conspiring to distribute oxycodone and oxymorphone.

In statement issued after the verdict, U.S. Attorney for the Eastern District of Kentucky Robert M. Duncan accused Noel of contributing to the opioid epidemic.

“The defendant’s unlawful dispensing of powerful opioid pills contributed to the crisis currently affecting the Appalachian region, and our District, specifically,” Duncan said in the statement.

However, in a Facebook post made days after the verdict to both his personal page and to the Buffalo Drug, Inc., page, Noel struck back at the government, alleging that his case was an “alarming overreach.”

“The government’s job is to prove beyond the shadow of a doubt that I am guilty of the charge,” he wrote.

“They did not even come close!”

Noel claims in the post he spoke with Smithers twice, once to warn the doctor that if the pharmacy could not verify his prescriptions with his office, they would no longer be filled, and again to inform Smithers that one drug he had prescribed to be given every eight hours could only be given every 12 hours.

Noel claims in the post that he would only fill the prescriptions for 60 Opana, even if Smithers wrote the prescription for 90, but that he did not benefit from the change.

“Not only did I lose the profit off of 30 pills, I lost the business of many customers due to my policy,” he wrote in the post.

Noel also claims that he “kicked out” members of the drug trafficking organizations, only two of whom received more prescriptions at Buffalo Drug than at his closest independent competitor, which he claims filled twice as many prescriptions for the same people and had one of their customers overdose.

Noel also claims in the post that he could not have received a fair trial in Pikeville.

“The trial was in Pikeville ... and we were so sure we had the case won that we did not even put on our expert witness,” Noel wrote. “With all the negative publicity about the opioid crisis there is no way any defendant has a chance in court, especially on foreign soil. For this I have lost my license, my business and face prison time and we did not break one law.”

Noel faces a maximum sentence of 20 years in prison at his sentencing, currently set for Dec. 16.

However, he filed a motion last week, asking that the judgment against him be vacated, on the grounds that the jury was “confused.”

“It is the position of defendant that the evidence was exaggerated by the government’s presentation, that the jury was thereby confused, that the so-called “red flags” as was restated by several witnesses and relied upon extensively by the government both in evidence and in argument is and was confused as some standard of care, the violation of which presented as guilt notwithstanding the Court’s instructions on the subject,” Noel’s attorney wrote in the motion. “The extremely short duration of the jury’s deliberation on its face did not allow for reading those instructions much less considering the exhibits presented.”

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