For years and years, Dr. Todd Calhoun’s vanity licence plate caused almost no one to bat an eye. If another driver did glance at it and chuckle, Calhoun, an anesthesiologist at North York General, assumed they worked in a hospital too.

His licence plate read: FENTANYL.

Fentanyl, an opioid painkiller that is 50 to 100 times more powerful than morphine, is commonly used in anesthesia. Over the last several years, it has also become a particularly lethal component of the ongoing opioid crisis, contributing to a rising number of overdose deaths across Ontario, the rest of Canada and the U.S. as it is misused, abused, and ingested unwittingly.

Last month, Calhoun received a notice from the Ministry of Transportation that his licence plate had been terminated and must be returned to the province. He says he was happy to comply: he himself lodged a complaint with the ministry to avoid paying the fee to get a new personalized plate.

A spokesperson for the ministry says it received a total of three complaints related to the FENTANYL plate, and that “it was determined that the plate in question is objectionable under the existing Personalized Licence Plate (PLP) criteria.” The ministry’s guidelines for objectionable vanity plates include “reference to the use of or sale of legal or illegal drugs.”

Calhoun says the plate was a birthday gift nearly 20 years ago from his spouse, who doesn’t work in medicine and who tried a few other anesthesia-related words before discovering FENTANYL was available. When Calhoun first attached it to his car in 2000, “nobody would ever know what fentanyl was.”

“Every once in a while, you’d be driving and somebody looks at it and starts laughing, so you know they obviously work in the ICU (intensive care unit) or the operating room,” he says.

“It was not a drug of abuse out there, it was not a street drug. It was a hospital drug, as it should be.”

Then, last May, Calhoun saw an article in the Star about Ontario drivers who had been asked to return their vanity plates by the province. (The offending plates were VI6SIX, NTFADA, REV JO, and JEHAD, all withdrawn because they were deemed to be religious references. Retired reverend Joanne Sorrill and plateholder Jehad Al Iweiwi were eventually permitted to keep theirs.) The story contained a list of the criteria under which the ministry might reject or recall a personalized plate, including the drug reference category.

Soon after, Calhoun was driving his family to Canada’s Wonderland. As the car idled at a red light, a man knocked on the car window. He said he had prescriptions for fentanyl and asked if he could get into the back seat.

Calhoun rolled up the window and zoomed away. “I thought, ‘Oh gosh. OK, now it’s time.’”

Fentanyl has become the drug most commonly involved in opioid-related deaths in Ontario, rising 548 per cent between 2006 and 2015. Opioids killed an average of two Ontarians every day in 2015, the last year for which figures are available.

Asked if it ever occurred to him that it might be inappropriate to drive around with a FENTANYL licence plate in the middle of an opioid crisis, Calhoun said that it did.

“I’ve been wanting to get rid of it, but basically I’ve got a very busy life,” he says. He has two young children and an active practice at the hospital. Besides, no one in 17 years had ever complained to him about it, he says. Border agents questioned what the plate meant when he drove into the U.S., but his answer always satisfied them. In other words, Service Ontario did not exactly beckon.

“I’d rather play with my kids than change my (licence plate),” Calhoun says.

That changed when the man knocked on his window, he recalls: “Now it’s at the top of my list of things to do.”

But Calhoun says that when he visited Service Ontario, they told him he couldn’t just trade in his own objectionable licence plate for an acceptable one. If a driver returns a personalized licence plate, that person would have to pay $310 for a new one. If the ministry recalls a personalized licence plate because of a complaint, however, the plateholder has the option to order a new personalized plate at no extra charge or apply for a refund.

“So I go home and I write a letter to the minister, saying I’m complaining about my own licence plate,” Calhoun says. The Ministry of Transportation says it received three complaints about the FENTANYL personalized plate. Calhoun thinks the other complaints might have been lodged by his friends, who offered to help because the process was taking so long. The ministry says the identities of the complainants can’t be divulged for privacy reasons.

Three weeks ago, Calhoun got a notice informing him that somebody had complained about his vanity plate and he had two weeks to send in a rebuttal. “So I called them up and said, ‘I’m the one who complained . . . I’m still complaining. I want to get rid of it.’ ”

They told him to wait out the rebuttal period. So he did, and finally traded in his FENTANYL plate for another personalized plate last week.

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Also last week, Manitoba Public Insurance asked the holder of an “ASIMIL8” vanity plate to surrender it. The phrase is a reference to the fictional alien Borg race from Star Trek, but the insurer had received complaints it was offensive to indigenous people. In March, the Nova Scotia government withdrew a man named Lorne Grabher’s personalized plate, because without context his “GRABHER” vanity plate could be read as promoting violence against women.

Calhoun says he’s relieved to be rid of the FENTANYL plate, which he replaced with a much more innocuous anesthesia-related phrase: DR DORMIR, French for sleep doctor.

“At least I’m not going to have anybody knocking on the windows,” he says.