Licence Appeal Tribunal File Number: 16077/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:
Gabriel Beaulieu
Appellant
and
Registrar of Motor Vehicles
Respondent
DECISION
ADJUDICATOR: Dr. Erica Weinberg
APPEARANCES:
For the Appellant: Gabriel Beaulieu, Self-represented
For the Respondent: Ian Sookram, Representative
HEARD by teleconference: August 8, 2024
OVERVIEW
1Gabriel Beaulieu (the "appellant") appeals from the decision of the Registrar of Motor Vehicles (the "Registrar" or the "respondent") to suspend their Class G licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the "Act") after the Registrar received requested up-to-date medical information.
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 severe alcohol/substance use disorder, that is likely to significantly interfere with their ability to drive a vehicle of the appropriate class 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 they suffer from severe alcohol/substance use disorder and deny 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 of the applicable class safely.
7To resolve that issue, I will address the following questions:
i. Does the appellant suffer from severe alcohol/substance use disorder?
ii. If so, is this likely to significantly interfere with their ability to drive a motor vehicle of the applicable class safely?
8The Registrar bears the burden of proving on a balance of probabilities that the answer to each of the above questions is "yes."
RESULT
9Having considered all the evidence and submissions 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 of the applicable class safely and I confirm the Registrar's decision to suspend the appellant's driver's licence.
ANALYSIS
Does the appellant suffer from severe alcohol/substance use disorder?
10The evidence presented at the hearing establishes, on a balance of probabilities, that the appellant suffers from a medical condition, namely severe alcohol/substance use disorder.
11The Registrar's position is supported by the June 25, 2024 substance use assessment form completed by the appellant's then military physician, Dr. Collins.
12By letter dated May 13, 2024, the Registrar required the appellant to file an up-to-date assessment from their treating physician. The letter stated that the assessment must include a completed substance use assessment form and confirmation that the appellant is compliant with their healthcare practitioner's recommendation regarding their consumption of alcohol.
13In the June 25, 2024 completed substance use assessment form, Dr. Collins: checked off that the appellant suffers from severe substance use disorder and the substances that apply are alcohol and illicit substances, specifically cocaine; wrote that the cocaine use disorder has been in remission for 6-12 months, with the last positive biochemical test result for cocaine being August 16, 2023; and the appellant's reported abstinence from alcohol is discordant from biochemical testing, with the last positive alcohol test being May 22, 2024.
14I take note of the facts from the respondent's written submissions that the appellant's driver's licence: was previously suspended for medical reasons on May 22, 2023; was reinstated on January 24, 2024 pursuant to a Licence Appeal Tribunal decision; and was most recently suspended for medical reasons on July 19, 2024 following the receipt and review of Dr. Collins' June 25, 2024 completed substance use assessment form.
15The appellant testified that in March 2023, they voluntarily reported to the psychiatric ward of a military hospital and was subsequently transferred to another hospital for 'detox'. The appellant stated that, at that time, they were having problems in their life and they were using alcohol and cocaine to take their mind off their problems or to numb things. They further testified that following their release from hospital, they were put on probation at work ('medical category'), with their advancement in the military being put on hold, were subject to frequent random blood and urine testing for substances at a military hospital, and met with Dr. Collins, approximately every three weeks until Dr. Collins recent departure.
16The appellant testified that around March or April 2024, they were told by a nurse that they were no longer required to do random blood and urine screening for substances or that the frequency of random testing for substances was to be significantly reduced. The appellant stated that based on this information they thought they could begin drinking alcohol socially again, which they then did.
17The appellant stated that they attended a social gathering after work on May 21, 2024, where they drank one beer. On May 22, 2024, the appellant was subject to random blood and alcohol testing for substances, which revealed a positive test for alcohol.
18The appellant denies that they currently suffer from either severe alcohol use disorder or severe cocaine use disorder. They rely on several facts including: they were subject to blood and urine screening for substances for about one year; they have abstained from alcohol once again; and they do not crave alcohol. However, the appellant did admit that they still 'think' about alcohol.
19I prefer the written evidence of Dr. Collins regarding the appellant's diagnosis of severe alcohol/substance use disorder, specifically the use of cocaine. Dr. Collins is qualified to make such a diagnosis. In addition, Dr. Collins has known the appellant since March 2023, has submitted a number of medical reports to the Registrar and, according to the appellant's testimony, has had numerous medical visits with the appellant.
20I assign less weight to the appellant's self-assessment that they do not suffer from severe alcohol/substance use disorder from the use of cocaine. The appellant did not submit any medical evidence to dispute Dr. Collins' June 2024 diagnosis of severe substance use disorder. I prefer the objective, medically supported assessment of Dr. Collins over the appellant's subjective self-assessment.
21I find that the Registrar has established on a balance of probabilities that the appellant suffers from severe alcohol/substance use disorder.
Is the appellant's medical condition likely to significantly interfere with their ability to drive a motor vehicle of the applicable class safely?
22I find that the Registrar has proven on a balance of probabilities that the appellant's medical condition of severe alcohol/substance use disorder is likely to significantly interfere with their ability to drive a motor vehicle of the applicable class safely.
23The Registrar's representative stated that severe alcohol/substance use disorder can significantly interfere with a driver's ability to drive safely and presents a safety risk to other road users. They further stated, in accordance with the Registrar's letter dated July 9, 2024, that in order to consider reinstatement of the appellant's driver's licence they require confirmation that the appellant has remained abstinent from alcohol and drugs for a period of one year and this period may be reduced to six months if the appellant's healthcare practitioner confirms that the appellant has successfully completed an alcohol/drug treatment program and is supportive of the appellant's driving privilege.
24Section 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.
25The Registrar relies on the CCMTA Standards, in particular Chapter 15.6.3 (Substance Use Disorder), plus internal policies at the Ministry of Transportation. Chapter 15.6.3 provides that all drivers suffering from Substance 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.
26The respondent's representative stated that: although, as of the date of the hearing, it has been almost 12 months since the appellant's last reported positive cocaine test, the last confirmatory abstinence information received from a healthcare professional was on June 25, 2024, at approximately the 10-month mark for abstinence from cocaine; it has been less than three months since the appellant's last reported positive alcohol test; the appellant's physician has not supported the reinstatement of the appellant's driving privilege; and the appellant has not yet successfully completed a drug rehabilitation program.
27The appellant stated that they: do not suffer from alcohol/substance use disorder; do not suffer from any medical condition that significantly interferes with their ability to drive a motor vehicle safely; have a clean driving record; and have never driven under the influence of alcohol or substances. I take note of the fact that the appellant's 'Extended Driver Record Search for Criminal Code Convictions' shows no evidence of alcohol-related infractions.
28The appellant testified that they believe they were misled by the military when they thought they could drink alcohol socially after being told in March or April 2024 that the frequency of their random drug screening was significantly reduced. However, when questioned, the appellant admitted that they never directly asked Dr. Collins whether this meant they could begin drinking alcohol socially, nor did Dr. Collins ever volunteer this information at any appointment.
29I agree with the respondent that the 2024 written evidence from Dr. Collins states that the appellant has not recently successfully completed a supervised treatment program as a result of their reported condition. I also take note that Dr. Collins' November 2023 completed substance use disorder form states that the appellant "Participated in substance use disorder counselling but did not complete. Discharged due to poor attendance".
30The appellant confirmed that they did not complete the above treatment program and testified that: the counselling was in a different city from where they worked/lived; they had to rely on others to transport them back and forth; and they stopped attending the treatment program around September 2023. Although the appellant testified that they found the counselling sessions beneficial, they "thought they had no issues" and did not look for any other formal substance use program until after the most recent suspension of their driver's licence. The appellant did, however, meet with a social worker on the military base approximately every three weeks for approximately one year.
31The appellant testified that since July 3, 2024, they have been in a formal weekly 1:1 Zoom substance use treatment program. The appellant stated that they: have four sessions left; have been learning 'tricks to avoid relapse'; may request an extension of the sessions for an additional four weeks; and are considering applying for a spot in an in-patient substance use program.
32While the CCMTA Standards are well-reasoned and provide assistance, every case must be considered on its own facts.
33Although I am not bound by the CCMTA Standards, I find them to be reasonable. The use of alcohol or drugs such as cocaine affects the functions necessary for driving including reaction times, visual acuity, judgement and insight, alertness and motor co-ordination. The use of alcohol or drugs 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 or drugs, intend not to drive when intoxicated, their assessment of their ability to drive will likely be affected by having consumed alcohol or drugs.
34Given the evidence, I am persuaded to apply the CCMTA Standards in the circumstances of this case.
35I 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. I agree with the respondent that the most recent medical evidence (June 25, 2024) indicates that, at that time, the appellant had been abstinent from cocaine for approximately 10 months and abstinent from alcohol for one month. I also acknowledge that as of the date of the hearing, it has been almost 12 months since the appellant's last positive cocaine test on record and almost three months since the appellant's last positive alcohol test on record.
36I agree with the respondent that no treating healthcare provider has supported the early re-instatement of the appellant's driver's licence. The appellant testified that at least once in 2023, prior to their hearing before the Tribunal in January 2024, Dr. Collins verbally told the appellant that they were not yet willing to provide the appellant with a favourable recommendation in support of regaining their driving privilege.
37Moreover, based on the evidence and submissions before me, I find on a balance of probabilities that the appellant currently lacks sufficient insight into their condition of alcohol/substance use disorder. 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 their treatment regime and any conditions of licencing. Insight is an important consideration when determining fitness to drive. The appellant currently denies that they suffer from alcohol/substance use disorder. They testified that they never received confirmation from Dr. Collins, nor did they ask Dr. Collins if they could start drinking alcohol socially following the change in frequency of their substance use testing. In the June 2024 substance use assessment form, Dr. Collins wrote, "...[appellant's] reported abstinence from alcohol is discordant from biochemical testing...". Although I am hopeful that the appellant will complete their current treatment program, it is clear that they did not complete their program in 2023, nor did they reach out for assistance in finding an alternative treatment program, thinking that they had no ongoing substance use issues.
38Based on the totality of the evidence and submissions available to me, I accept the respondent's submission that further time and medical information should be submitted is reasonable, keeping in mind public and road safety.
39I commend the appellant for their recent efforts to remain abstinent and for reconnecting with a substance use treatment program. I also acknowledge the burden that the lack of a driver's licence and the diagnosis of alcohol/substance use disorder has had and is having on the appellant's personal and work life. However, driving is a privilege, not a right.
40I am satisfied on a balance of probabilities that the appellant's medical condition is likely to significantly interfere with their ability to drive safely.
Conclusion
41I find that the Registrar has discharged the onus of establishing, on a balance of probabilities, that the appellant suffers from severe alcohol/substance use disorder, that is likely to significantly interfere with their ability to drive a motor vehicle of the applicable class safely.
ORDER
42For 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.
Released: August 28, 2024
__________________________
Erica Weinberg
Adjudicator