Inside an Ontario fentanyl trafficking ring involving a doctor and a pharmacist

In 2010, Liridon Imerovik and his father got in a car accident. Imerovik, who also goes by the nickname Donny, was prescribed percocet for managing the subsequent pain in his shoulders and back. He was in his early 20s at the time.

Imerovik later became addicted to fentanyl. 

He started to pull away from his family: his mom, dad and younger sister are described as “stable and loving” in court documents. At one point, his weight ballooned to around 300 pounds.

His addiction would also underpin his integral role in a prescription fentanyl trafficking ring that spanned from the Toronto area to Sudbury and involved a pharmacist and a family doctor  — and another dealer who also struggled with an opioid addiction. 

They would be convicted or plead guilty to fentanyl trafficking or possession offences for their roles in the scheme that lasted from 2015 to 2016. The doctor and pharmacist are currently awaiting their sentences. Three others either had their charges withdrawn or were acquitted.

Court documents obtained by Global News from the Newmarket, Ont., proceedings recount the details of the operation involving thousands of prescription patches and how police brought it down in 2016. 

These days, many overdose deaths across the country are linked to bootleg, non-pharmaceutical fentanyl that has tainted the illicit drug supply. 

But this unusual case, one of the only times a medical doctor in Canada has been convicted for trafficking fentanyl, provides a glimpse into the role that some healthcare professionals played in what has become the worst overdose crisis in Canadian history.

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Sometime after his car accident, Imerovik was hired to do legitimate deliveries for the Weston PharmaChoice pharmacy north of Toronto.

He was initially paid $500 a week as a delivery person, according to his sentencing decision at the Superior Court of Ontario released this January.

Imerovik testified that he intentionally pursued that job “so that he would have ready access to opioids.” There was a medical clinic located at the pharmacy, where a physician there prescribed him 100 oxycontin pills a month, according to that document.

After that physician left the clinic, Imerovik got involved with the fentanyl trafficking scheme involving Shereen El Azrak, a pharmacist at PharmaChoice, and another doctor, George Otto in August 2015, according to Imerovik’s sentencing decision. Otto is referred to as “Dr. X” in that document as his trial was still pending when it was released. Otto ran a family medical practice in Toronto.

Imerovik began consuming fentanyl patches because he could no longer get high from oxycontin alone, the document states. 

“Mr. Imerovik testified before me that he trafficked the fentanyl knowing how dangerous it was and the potential for harm to others,” Justice Michelle Fuerst said in Imerovik’s sentencing decision. “He said that his main concern was having a constant supply of fentanyl for himself, because of his own addiction to it.” 

Imerovik brought patients or patient information to Dr. Otto, collected the prescriptions and delivered them to El Azrak, the pharmacist. He would then collect the fentanyl dispensed by her, and traffick it to another dealer, Sean Holmes, whom Imerovik brought into the scheme, according to his sentencing decision. 

For each patient, Dr. Otto got a kickback of $1,500 and El Azrak got $500. Imerovik told the court that he was paid $1,000 per week as “commission,” according to the sentencing document.

“During the period of his involvement, an estimated 2,780 fentanyl patches of maximum strength were dispensed by the pharmacist,” continued Justice Fuerst. “By Mr. Imerovik’s admission, most of those patches were trafficked by him.”

The court estimates that 6,400 patches containing 100-micrograms of fentanyl were dispensed by El Azrak between March 2015 and January 2016. 

Imerovik and El Azrak, the pharmacist, regularly communicated via text message about the deals, according to his sentencing decision. They agreed that Otto would write prescriptions for 30 patches of fentanyl, for each of four patients per week. 

“From the texts, Shereen (El Azrak) believed this number could go through the pharmacy without drawing attention to the scheme,” according to the Superior Court decision from September 2018 in which El Azrak was convicted of fentanyl trafficking and possession of fentanyl for the purpose of trafficking. (That same decision acquitted another man who had been tried alongside her.)

El Azrak had become concerned about “some of the younger patients Donny was bringing in,” wrote Justice Chris de Sa in that decision.

“She knew fentanyl was bad and there were risks. She testified that she started to restrict the number of ‘new fentanyl patients’ and started to only dispense to patients she knew. She was trying to control the situation.”

But in September of 2015, about a month into the operation, Dr. Otto arranged with El Azrak to bump up the number of fentanyl prescriptions to six per week, according to Imerovik’s sentencing document.

A month later, the police took notice.

Officers with the York Regional Police Service began to investigate allegations of fentanyl trafficking in the area around October 2015, according to the El Azrak decision. 

The police service received information from the Sudbury Police that a trafficker named Sean Holmes was travelling there to obtain his drug supply. 

Holmes pleaded guilty in 2017 to possessing fentanyl for the purpose of trafficking in April of 2017, when he was 33 years old. According to Holmes’ sentencing decision later that year, Holmes also became addicted to opioids in his early 20s and was on and off methadone over the years. It started with percocets and oxycodone and eventually included fentanyl.

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In Vaughan, York police began conducting surveillance in the Imerovik case. One night, officers observed Holmes and his girlfriend arrive at the Hotel Novotel just after 11 p.m. on Jan. 19, 2016, according to the El Azrak decision. They checked into a room on the third floor.

Shortly after, police saw Imerovik arrive and go to Holmes’ room. He left carrying a flowered gift bag, which he was not carrying before, according to that court document. 

As Imerovik drove away, police pulled him over and arrested him for trafficking a controlled substance. 

The police recovered $31,905 in cash from the flowered gift bag, according to the El Azrak decision. In the front right pocket of Imerovik’s pants, police found two prescription labels from the lids of fentanyl prescription boxes. Both were from Weston PharmaChoice. And in his left pants’ pocket, police found an envelope containing a list of names broken down by weeks. Each week had six names divided into weeks. 

All of the patients on the list had been dispensed fentanyl from that pharmacy. 

Police also carried out a search warrant of Holmes’ room at the Hotel Novotel, where they arrested him and his girlfriend, who eventually had the charges against her withdrawn.

A total of 165 fentanyl patches, worth approximately $33,000, were seized from the hotel room. A search of Imerovik’s home address yielded police 88 patches, most of which were in a box with prescription labels attributed to Otto, and more than $14,000 in cash was found in his bedroom closet, according to the El Azrak decision.

In March 2016, police arrested Dr. Otto and searched his office and car. Officers found a Sun Life Insurance bag containing a number of patient labels in the trunk of the car, according to the El Azrak decision. The names listed on the labels were all patients who had been dispensed fentanyl from Weston PharmaChoice.

During a search of his bedroom, police found a sheet with a list of names, which also corresponded to the fentanyl prescriptions dispensed by El Azrak, according to the decision in her case.

A couple weeks later, York Regional Police announced that Otto, El Azrak, and others had been charged with fentanyl trafficking and possession as part of the ring.

York Regional Police announce charges against George Otto, Shereen El Azrak, and others in 2016.

At the time, a lawyer representing Otto said he had no involvement in the scheme.

“Dr. Otto is shocked by the allegations,” the lawyer said in a statement to the Toronto Star. “He denies any criminal wrongdoing and intends to vigorously defend himself against the allegations.”

Otto’s indictment shows that a jury convicted him of one count of fentanyl trafficking on June 26, 2019. His sentencing hearing will commence on Oct. 4.

His current lawyer, Dan Stein, told Global News in an email that he had no comment for this story.

According to his profile on the College of Physicians and Surgeons Ontario website, Otto graduated from McMaster University in 1984. Prior to his arrest, Otto had faced a number of disciplinary proceedings by the regulatory body regarding professional misconduct. The instances date back to 2012 and include improper billing and paperwork and failure to respond to requests for records from patients in a timely way. 

He has been fined thousands of dollars for these instances. His licence was suspended in February. 

In 2018, El Azrak had a trial by judge. She was found guilty of fentanyl trafficking and possession.

El Azrak is currently facing an interim suspension by the Ontario College of Pharmacists. Her profile on the College’s website outlines her fentanyl-related convictions and complaints regarding narcotics prescribing practices.

El Azrak’s sentencing decision in her criminal matter is scheduled for September at the Newmarket courthouse. Her lawyer, Kim Schofield, told Global News through her assistant that she had no comment. 

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For the other dealer, Holmes, the Toronto trafficking scheme was not the first time he faced criminal prosecution. He was convicted for drug possession in 2007, in what would be the first of a number of other such convictions and stints in jail, according to the sentencing decision.

“His use of opiates continued while he was in the penitentiary in 2010 and 2011,” states Justice Dwyer in his August 2017 sentencing decision of Holmes. “When he finished his sentence, he enjoyed a period of relative sobriety and held down a good job in the mining industry.”

But Holmes began using fentanyl in 2013. “For the next 2 to 3 years, his use of the drug increased to the point … when he was using 7 to 9, 100 microgram patches a day. This would be an extremely high rate of use indicated a person is severely addicted,” Justice Dwyer continues.

“Technically, Mr. Holmes was an addict trafficker, but there was a very big commercial aspect to his trafficking.”

Holmes was sentenced to a total sentence of 77 months, according to his sentencing decision.

“Mr. Holmes, good luck,” concluded Justice Dwyer. “I don’t think anybody wants to be addicted to drugs, and I hope that you are able to overcome it.”

As for Imerovik, he pleaded guilty to two counts of trafficking fentanyl, and one count of possession of fentanyl for the purpose of trafficking for his role in the operation.

In his sentencing decision, Justice Fuerst of the Superior Court stated that Imerovik stopped using fentanyl and used only oxycontin after he was released on house arrest bail with his parents. He slowly tapered his oxycontin use with the help of methadone overseen by a physician in 2016.

He started going to the gym and has dropped 100 pounds, the document states.

“He discussed his addiction with his parents and sister, and became more communicative with them,” said Justice Fuerst. “His parents and sister testified before me that once he told them about his drug addiction, they supported him in his efforts to get clean. They are happy with his progress and remain supportive of him.”

But as a result of his arrest, the document states, his mother lost her security clearance and was unable to continue working as a security screener at Pearson Airport.

Justice Fuerst sentenced Imerovik to three concurrent sentences of nearly six years in a minimum security jail. 

His lawyer said at the time that Imerovik agrees that fentanyl is an “insidious substance,” but that “much of the blame for its abuse lies with the pharmaceutical companies and the medical profession who touted it as a miracle drug.”

Justice Fuerst added that once Imerovik has served his sentence, he intends to move to Macedonia, his mother’s native country. “He plans to attend university there and to start a new life working with people suffering from drug addiction.”