Prosecutor Tamara Holland said the county's forensic pathologist noticed many of the overdose deaths they saw were getting prescriptions from the same doctors.
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The federal grant of more than $350,000 received by the county has allowed them to hire an investigator specifically for prescription drug diversion.
"Prescription drugs are linked to more fatal overdoses than illicit drugs," Holland said.
As a result of their investigations, four doctors were arrested and charged in Montgomery County in November of 2019. Their cases are not linked.
Dr. Miguel Juan Flores of Conroe is facing charges of prescribing controlled substances other than for medical purposes and practicing medicine in violation of subtitle.
Prosecutors said he prescribed to someone he knew or should have known was an abuser and prescribed to someone without a legitimate medical purpose. They linked him to one overdose.
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Dr. Flores is prohibited from prescribing Schedule II controlled substances, treating patients for chronic pain as defined by board rule, and prescribing Schedule III, IV, and/or V controlled substances other than in a hospital setting.
Dr. Emad Bishai of Conroe faces five counts of practicing medicine in violation of subtitle, and four counts of prescribing controlled substances other than medical purpose.
Four overdoses are linked to Dr. Bishai, according to the Montgomery County District Attorney's Office.
"There were enough red flags that the doctor should have known they were high risk," Holland said.
Two counts of practicing medicine in violation of subtitle were filed against Dr. Hussamaddin Al-Khadour whose primary practice is listed in Houston, but also shows having an office in Shenandoah.
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The DA's Office said he was running a pain management clinic without a pain management certificate. Holland said it's required for offices prescribing more than 50-percent of patients with a particular type of controlled substance.
Prosecutors also charged Dr. Fadi Ghanem with three counts of prescribing controlled substances other than for medical purposes and three counts of practicing medicine in violation of subtitle.
They linked him to three overdoses, according to the DA's office.
She said they have also had doctors report employees who stole prescription pads and the DA's Office has filed charges against those people.
All four doctors cases are currently pending in court.
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