When something kills 42,000 Americans in a single year, people take note, and the opioid epidemic is in the spotlight.
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Doctors are under serious scrutiny and the California Medical Board is keeping a close eye.
The CURES system is their automated database looking for red flags in prescription patterns.
"When that number pops up, they immediately focus in on a particular doctor to figure out if these prescriptions should've been authorized," said legal analyst Tony Capozzi.
The medical board is now accusing Tulare family practice Dr. Thomas Evans of dangerous patient care.
Between 2014 and 2016, he prescribed a man with a history of drug use thousands of opioid pills -- as many as 120 a month -- for back pain.
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Investigators say he did it without regular visits, without ever referring the patient to a specialist in pain management or addiction medicine, and going for months without documenting any discussion about the need to taper off the substances.
And Dr. Evans has a history with the medical board, settling two previous accusations, including one involving a patient who overdosed on prescription pain medication.
"If it's the same issue, then I think the argument is, you should've known better," Capozzi said.
He says there are some instances when doctors need to prescribe a large number of opioids.
Dennis Thelen, an attorney for Dr. Evans, tells Action News the doctor had a close relationship with the patient and knew he had chronic pain.
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"And if it's helping him, I think the doctor would have some legitimate argument to say 'I'm here to help him. I'm not here to overprescribe and cause damage,'" Capozzi said.
The Centers for Disease Control didn't issue guidelines for prescribing opioids until 2016, but the state of California has filed hundreds of accusations against doctors for alleged overprescription before then.
The attorney general's office is pushing to revoke or suspend Evans' medical license or put him on probation again, as it did for five years after his 2007 accusation.
His attorney says Dr. Evans will fight it.