Licence Appeal Tribunal File Number: 15127/MED

In the matter of an appeal under subsection 50(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”), from a decision of the Registrar of Motor Vehicles to suspend a licence pursuant to Section 47(1) of the Act.

Between:

Sean Hart

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

ADJUDICATOR:

Dr. Erica Weinberg, Member

APPEARANCES:

For the Appellant:

Sean Hart, Self-Represented

For the Respondent:

Ian Sookram, Representative

HEARD by teleconference: September 7, 2023

OVERVIEW

1Sean Hart (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (the “Registrar”) to suspend their Class GM licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”) after the Registrar received a report from a treating health care provider that the appellant suffers from a medical condition that may affect their safety to drive.

2The Registrar has the authority under s. 47(1)(g) of the Act to suspend or cancel a driver’s licence for any sufficient reason. Section 14(1)(a) of O. Reg. 340/94 under the Act (the “Regulation”) states that a holder of a driver’s licence must not suffer from any mental, emotional, nervous or physical condition or disability likely to significantly interfere with their ability to safely drive a motor vehicle of the applicable class safely. Under s. 14(2)(b) of the Regulation, the Minister of Transportation may require a driver to provide satisfactory evidence that they are able to drive safely.

3The Registrar takes the position that the appellant suffers from a medical condition, namely Alcohol Use Disorder, that is likely to significantly interfere with their ability to drive safely and that this provides sufficient reason to suspend their licence under s. 47(1)(g) of the Act.

4The appellant appeals the suspension under s. 50(1) of the Act. They deny that they suffer from Alcohol Use Disorder and deny that they suffer from a medical condition which interferes with their ability to drive safely.

5Pursuant to section 50(2) of the Act, after a hearing the Tribunal may confirm, modify, or set aside the decision or order of the Registrar.

ISSUES

6The issue in this appeal is whether the appellant suffers from a medical condition that is likely to significantly interfere with their ability to drive a motor vehicle safely.

7To resolve that issue, I will address the following questions:

i. Does the appellant suffer from Alcohol Use Disorder?

ii. If so, is this likely to significantly interfere with their ability to drive a motor vehicle safely?

RESULT

8Having considered all the evidence and for the reasons that follow, I find that the Registrar has satisfied its burden to establish that the appellant suffers from a medical condition that is likely to significantly interfere with their ability to drive a motor vehicle safely and I confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

ANALYSIS

Does the appellant suffer from Alcohol Use Disorder?

9The evidence presented at the hearing establishes, on a balance of probabilities, the Registrar’s allegation that the appellant suffers from a medical condition, namely Alcohol Use Disorder.

10On May 27, 2023, the appellant was involved in a motor vehicle accident, which, as described below, appears to have occurred subsequent to the appellant having consumed alcohol. The appellant was transported to hospital following the accident.

11The Registrar’s position is supported by medical reports completed by Drs. A. and K.

12On May 31, 2023, hospitalist, Dr. A., completed a Medical Condition Report indicating that the appellant was suffering from Alcohol Use Disorder.

13In a narrative letter dated June 16, 2023, the appellant’s family physician, Dr. K., indicated that: the appellant was attending an appointment for medical follow-up for a history of Alcohol Use Disorder; the Alcohol Use Disorder was in early remission; and the appellant had abstained from alcohol since their admission to hospital.

14Furthermore, on a completed Substance Use Assessment form dated July 14, 2023, Dr. K. indicated that the appellant had a diagnosis of severe Substance Use Disorder to Alcohol (Alcohol Use Disorder). In the Comments Section (Part 3), Dr. K. indicated that the appellant has complied with the treatment plan including: follow-up with Dr. K.; attending “AA” daily; attending “ADAPT” [Alcohol, Drug and Gambling Assessment Prevention and Treatment Services] regularly for counselling; and abstaining from alcohol.

15The appellant argues that they do not suffer from Alcohol Use Disorder. They rely on the facts that they: did not and have not suffered from alcohol withdrawal symptoms, even after discharge from hospital; currently have no cravings for alcohol and don’t feel the need or have the desire to drink alcohol; do not have a family history of Alcohol Use Disorder; and have not suffered from the negative effects of alcohol.

16The appellant candidly admitted to an increase in alcohol consumption for the past two years. This included drinking “not much” during the week and “a couple bottles of wine” on the weekends. On reflection, the appellant admits during this time to being “stretched” between work and the increased stress from their father being in palliative care, marital problems which resulted in divorce, selling their marital home, not being open or reaching out for additional help and using alcohol to “numb the pain of thinking”.

17When questioned about the events on Saturday May 27, 2023, the appellant recalls being very excited about their son moving in with themselves, having consumed “at least a couple of glasses of wine” in the late afternoon and deciding to drive to pick up food at around 8 p.m. The appellant does not recall the motor vehicle accident which occurred enroute, stating that they were “knocked out". The appellant admits to being in hospital for a few days for “observation” following the motor vehicle accident, recalls being prescribed medication for “alcohol withdrawal” while in hospital and taking the medication Naltrexone for one to two weeks at home following their discharge from hospital.

18I prefer the evidence of Dr. A. and Dr. K. regarding the appellant’s diagnosis of Alcohol Use Disorder. The named doctors are qualified to make such a diagnosis. The appellant testified that they were treated with “alcohol withdrawal” medication while in hospital. Moreover, as a licenced and duly qualified physician practicing in Ontario, I am aware based on my knowledge that the medication Naltrexone can be used in the treatment of Alcohol Use Disorder as a component of a comprehensive program (e.g., psychotherapeutic, psychological, and educational program) to support abstinence and decrease the risk of relapse. I take notice of this fact pursuant to s. 16(b) of the Statutory Powers Procedure Act, R.S.O. 1990, c. S.22.

19I assign less weight to the appellant’s evidence that they do not suffer from Alcohol Use Disorder. The appellant did not submit as evidence the records from their recent hospitalization that were in Dr. K.’s possession, nor did they submit any medical evidence to dispute Drs. A. and K.’s diagnosis of Alcohol Use Disorder. I prefer the objective, medically supported assessment of Dr. A. and Dr. K. over the appellant’s subjective self-assessment.

20I find that the Registrar has established on a balance of probabilities that the appellant suffers from the mental health condition of Alcohol Use Disorder.

Is the appellant’s medical condition likely to significantly interfere with their ability to drive a motor vehicle safely?

21I find that the Registrar has proven on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with their ability to drive a motor vehicle safely.

22The Registrar’s representative argues that Alcohol Use Disorder can interfere with a driver’s ability to drive safely and presents a safety risk to other road users. They further argue that in order to consider reinstatement of the appellant’s driver’s licence they require confirmation that the appellant has abstained from alcohol for a period of one year and that this period may be reduced to six months if the appellant’s healthcare practitioner confirms that the appellant has successfully completed an alcohol treatment program and is supportive of their driving privilege.

23Section 14(2)(a) of the Regulation allows the Registrar to consider the Canadian Council of Motor Transport Administrators Medical Standards for Drivers [February 2021] (the “CCMTA Standards”), when determining whether the requirements of s. 14(1) are met. The Tribunal may take the CCMTA Standards into consideration, although they are not binding on the Tribunal.

24The Registrar relies on the CCMTA Standards, in particular Chapter 15.6.3 (Substance Use Disorder) and internal policies at the Ministry of Transportation. Chapter 15.6.3 provides that all drivers suffering from Alcohol Use Disorder may be eligible for a licence if they meet the criteria for remission and/or have abstained for twelve months. It also states that earlier re-licencing may be considered upon favourable recommendation from an addiction specialist and/or treating physician recognized by the licensing authority, and the successful completion of a drug rehabilitation program.

25The appellant argues that he does not suffer from Alcohol Use Disorder, does not suffer from any medical condition that affects safety to drive, has a clean driving record, that they have never driven under the influence of alcohol, that if they were to drink alcohol they “usually would not drive unless it was an emergency” and that they “pose no risk”. The appellant indicated that the May 27, 2023 event: was an “embarrassment” to them; was something they “don’t usually do”; was an “unusual situation”; “was not them” as reflected in the five written character references submitted as evidence; and “won’t happen again”. The appellant further argues that he has put in a lot of effort and is committed to his “journey to better health” and has a plan going forward. This plan includes but is not limited to: maintaining abstinence; completing the current ADAPT module; attending AA meetings weekday mornings; meeting with/calling Ms. B., the social worker at ADAPT, when needed; setting boundaries; reaching out to their two main support persons when needed; and continuing with their positive changes to diet and exercise.

26While the CCMTA Standards are well-reasoned and provide assistance, every case must be considered on its own facts.

27Although I am not bound by the CCMTA Standards, I find them to be reasonable. The use of alcohol affects the functions necessary for driving including reaction times, visual acuity, judgement and insight, alertness and motor co-ordination. The use of alcohol impairs a driver’s judgement and behaviour towards others, including in determining whether they are fit to drive or not. Although a person may, when not under the influence of alcohol, determine never to drive when intoxicated, their assessment of their ability to drive will likely be affected by having consumed alcohol.

28Given the evidence, I am persuaded to apply the CCMTA Standards in the circumstances of this case. I acknowledge that when considering earlier re-licencing of a driver’s licence, the CCMTA Standards do not state a specific time period required for remission. In addition, I acknowledge that the appellant has abstained from alcohol for over three months and I commend them for the enormous effort already made in their journey towards better health and for the general knowledge they have gained regarding Alcohol Use Disorder. I accept that the appellant has or will soon complete the ADAPT program as recommended and I take note of Dr. K.’s August 14, 2023 note which states that the appellant continues “to attend AA and ADAPT and continues to abstain from all forms of alcohol ingestion”. However, based on the evidence, I find in this particular case that three months of abstinence is too early for reinstatement of the appellant’s driver’s licence. Nowhere does Dr. K. indicate that they support early reinstatement of the appellant’s driver’s licence. Furthermore, I find that the appellant currently has not gained enough insight into the medical condition of Alcohol Use Disorder as it applies to themselves. Despite testifying that on May 27, 2023, they drove within a few hours of consuming “at least a couple of glasses of wine”, being involved in a subsequent motor vehicle accident, being admitted to hospital for a few days following the accident, being given “alcohol withdrawal” medication while in hospital and taking Naltrexone following discharge from hospital, the appellant still denies or cannot accept that, on a balance of probabilities, they suffer from Alcohol Use Disorder. Insight is an important consideration when considering safety to drive. Insight means that a driver: is aware of their medical condition; understands how the condition may impair their functional ability to drive; and has the judgment and willingness to comply with a suggestive treatment regime. I accept the respondent’s submission that further time and medical information should be submitted is reasonable keeping in mind public road safety.

29I am satisfied on a balance of probabilities that the appellant’s medical condition of Alcohol Use Disorder is likely to significantly interfere with their ability to drive safely.

Conclusion

30I find that the Registrar has discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely Alcohol Use Disorder, that is likely to significantly interfere with their ability to drive a motor vehicle safely.

ORDER

31For the reasons set out above, pursuant to subsection 50(2) of the Act, I confirm the Registrar’s decision to suspend the appellant’s driver’s licence.