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A collection of different brand and dosages of Fentanyl patches. Users often cut patches into slices before ingesting them, not realizing that the drug is unevenly distributed.

TOM GANNAM/AP

A doctor and a pharmacist from the Toronto area have been charged with participating in a fentanyl trafficking ring that allegedly used phony prescriptions to sell large quantities of the deadly opioid on the streets of Sudbury, police said Wednesday.

Dr. George Otto and Shereen El-Azrak, the pharmacist, were charged with trafficking and possession of the drug, along with five others. In a series of January raids that uncovered the scheme, officers found $50,000 in cash and about 300 fentanyl patches worth an estimated $120,000.

Officials say it's rare for health workers to be charged with fentanyl trafficking.

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The sting coincides with a sharp rise in crime and overdose deaths related to the abuse of fentanyl, a prescription painkiller up to 100 times more toxic than morphine. The epidemic spans North America and has recently made headway in Ontario, where fentanyl is now the leading cause of opioid deaths. On Wednesday, 11 people were charged in a fentanyl bust in the Northwest Territories.

Andy Pattenden, spokesman for York Regional Police, which led the investigation in Ontario, said charges against two medical professionals in a case like this makes it unusual.

Dr. Otto, a resident of Richmond Hill, Ont., with a family practice in Toronto, has been disciplined by the provincial college of physicians before. In a decision last year, he admitted to lax assessments of patients applying for a Special Diet Allowance, which provides assistance to people with unusual dietary conditions such as lactose intolerance. He billed the province about $250,000 for the assessments between 2005 and 2012, the college's investigation found. Dr. Otto was fined $10,000 and had his medical licence suspended for two months.

He could not be reached for comment Wednesday.

Ms. El-Azrak, until recently a pharmacist at Humber River Regional Hospital in west Toronto, is being investigated by the Ontario College of Pharmacists over her alleged participation in the fentanyl ring but has no previous disciplinary history, said college spokesperson Lori DeCou.

Ms. DeCou said that the professional body takes drug trafficking allegations against its members seriously, while noting that complaints are rare.

"Is it a problem? Sure," she said. "We absolutely have a responsibility in that area."

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Pharmacy robberies to obtain fentanyl have become increasingly common in York Region, a suburban area north of Toronto, Mr. Pattenden said.

"For about the last two years or so, it's been more and more prevalent," he said.

Fentanyl overdoses are also a growing problem for the force. Mr. Pattenden said that users often cut patches into slices before ingesting them, not realizing that the drug is unevenly distributed. The prescription patches are normally worn on a patient's skin and release the drug into the bloodstream over two or three days.

The rise of "bootleg" fentanyl, made in illicit labs and mixed with heroin, has also made the drug more perilous, as users rarely know how much fentanyl they are consuming. As little as 2 milligrams of the drug can be lethal.

Ontario saw 173 fatal overdoses related to fentanyl in 2014, the last year for which figures are available, though authorities believe the number will be higher in 2015.

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