Licence Appeal Tribunal File Number: 17789/MED

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

Between:

Mathew Bowman

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

ADJUDICATOR: Dr. Isla McPherson, Member

APPEARANCES:

For the Appellant: Matthew Bowman, Self-Represented

For the Respondent: Melissa Litrenta, Agent

Held by teleconference: November 4, 2025

OVERVIEW

1Matthew Bowman (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (“Registrar”) to suspend his 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 an unsolicited Medical Condition Report (MCR) from a physician stating that the appellant suffers from a medical condition that may affect his ability to drive safely.

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 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 substance use disorder, that is likely to significantly interfere with his ability to drive safely and that this provides sufficient reason to suspend his licence under s. 47(1)(g) of the Act.

4The appellant appeals the suspension under s. 50(1) of the Act. He agrees he has been diagnosed with substance use disorder but states he has been abstinent for several months and denies that he suffers from a medical condition which interferes with his 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 his ability to drive a motor vehicle safely.

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

i. Does the appellant suffer from substance use disorder?

ii. If so, is this likely to significantly interfere with his ability to drive a motor vehicle 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 his 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 substance use disorder?

10The evidence presented at the hearing establishes that the appellant suffers from a medical condition, namely substance use disorder.

11The Registrar’s position is supported by:

i. Two MCRs dated August 8, 2023, and August 23, 2025, and

ii. Five Substance Use Assessment Forms dated November 3, 2023, February 8, 2024, July 12, 2024, November 5, 2024, and October 18, 2025.

12The Registrar submits that the appellant first came to their attention with a previous suspension related to substance use when Dr. CC submitted a MCR dated August 8, 2023. Dr. CC indicated the appellant suffered from a disorder that has a moderate or high risk of sudden incapacitation, or that has resulted in sudden incapacitation and that has a moderate or high risk of recurrence after he suffered a seizure due to alcohol/drug withdrawal. Upon receipt of this information, the Registrar suspended the appellant’s driver’s licence and requested a completed Substance Use Assessment Form.

13This form was completed by Dr. PC, dated November 3, 2023. Dr. PC reported the appellant suffered from severe substance use disorder due to illicit substances and/or non-prescribed pharmaceuticals, had suffered a seizure provoked by drugs within the past 12 months, had abstained from substances less than 6 months, and had completed a supervised treatment program. In response to the submitted form, the Registrar continued the suspension and requested confirmation that the appellant had remained abstinent from drugs for a period of 6 months.

14The appellant submitted an updated Substance Use Assessment Form completed by Dr. PC dated February 8, 2024. Dr. PC indicated the appellant suffered from severe substance use disorder due to illicit substances and/or non-prescribed pharmaceuticals, had suffered a seizure provoked by drugs within the past 12 months, had abstained from substances for 6-12 months, and had completed a supervised treatment program. The Registrar responded to the receipt of this form with reinstating the appellant’s driver’s licence.

15The Registrar continued to monitor the appellant’s condition with cyclical requests for Substance Use Assessment Forms. Dr. PC continued to complete these forms on both July 12, 2024, and November 5, 2024. Each form continued to document severe substance use disorder but with continued abstinence.

16A second MCR was submitted, leading to the current suspension under appeal. The MCR was completed by hospitalist, Dr. X dated August 23, 2025. The MCR reported that the appellant suffers from an uncontrolled substance use disorder due to “other substances”, and added the narrative comment, “opioid use disorder”. The Registrar responded to the submission by suspending the appellant’s driver’s licence and requesting the completion of an updated Substance Use Assessment Form.

17This form was completed by Dr. W, dated October 18, 2025. Dr. W documented the appellant suffers from moderate substance use disorder due to illicit substances and/or non-prescribed pharmaceuticals and has abstained for less than 6 months. Dr. W checked “yes” to the appellant completing a treatment program and added the comments, “currently enrolled at Pinewood and seeing MD at True North Medical”. Dr. W added further narrative comments that the appellant was on methadone treatment and found to have a urine drug screen positive for fentanyl which was thought to be due to a sleep medication. Dr. W further documented the appellant was prescribed a higher dose of methadone and Kadian, and he has had a urine drug screen negative for fentanyl since August 30, 2025.

18In response to receiving this information the Registrar kept the appellant’s licence under suspension and requested confirmation of abstinence from drugs for a period of one year, but this period could be reduced to 6 months if the appellant’s healthcare practitioner confirms completion of a drug treatment program and is supportive of driving privileges.

19The appellant testified that he had a seizure in the past due to substance use withdrawal when he had been trying to get clean on his own. He testified he had been abstinent for about 1.5 years when he was struggling with sleep and started to take a sleeping medication which had fentanyl in it. Once his doctor increased his methadone and Kadian, he was able to come off the sleeping medication without becoming sick or having a seizure and he has been abstinent since then.

20Under cross-examination the appellant was asked how long he was on the sleeping pills and how they were obtained. He responded that he was on the pills from February or March 2025 until August 21, 2025. He testified his doctor would not prescribe him anything to help with sleep and so he had to resort to buying a sleeping medication off the street.

21The appellant was asked about how he came to the attention of Dr. X as a hospitalist. He testified that he had been sick with stomach concerns but went to work and became sicker through the day. At the end of the day while driving home, he had no time to pull over and threw up in the car and accidentally drove off the road which resulted in becoming air-born and crashing his car. He was admitted to hospital with two broken vertebrae in his back. While he was in hospital, he did not have access to the sleeping pill with fentanyl and there was a delay is securing his methadone, and as a result he went into withdrawal which resulted in the MCR submission on August 23, 2025.

22The appellant further responded to questioning, testifying that he had began using illicit opioids 2-3 years ago. Within the first year of using opioids, he sought treatment at a True North clinic where he was started on methadone and had been followed weekly ever since. He has additionally started treatment at Pinewood Centre and provided a letter from an Addictions Counsellor KY. The letter is dated October 20, 2025, and describes the general type of treatments that are offered; that the treatment centre does not provide prognostic or diagnostic information, and that the clinical approach is to match the client’s intention to readiness to change. The only information provided that is specific to the appellant is that the appellant attended a phone assessment October 8, 2025, and two appointments in October 2025.

23While I understand the appellant has testified as to a period of abstinence since August 21, 2025 and that he has continued with weekly physician appointments and started a new treatment with an Addiction’s Counsellor, he has submitted no medical evidence from a physician or other healthcare practitioner to dispute that he no longer has a diagnosis of a substance use disorder. The latest medical evidence is from Dr. W and reports that he had a diagnosis of moderate substance use disorder less than a month ago.

24Based on the information available, I find that the Registrar has established on a balance of probabilities that the appellant suffers from substance use disorder.

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

25I find that the Registrar has proven on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with his ability to drive a motor vehicle safely.

26The Registrar’s submitted their position is also supported by the Canadian Council of Motor Transport Administrators Medical Standards for Drivers [February 2021] (the “CCMTA Standards”). Within these Standards, the Registrar relies on Chapter 15. This Chapter describes substance use disorders in general and the concerns with driving safely.

27This chapter cites that research indicates use of opioids can adversely affect driving performance, and the use of opioids results in depression of the central nervous system. It further outlines possible effects on the functions necessary for driving including blurred vision, slowed reaction times, sedation, tremors, muscle rigidity, impairment of shorter term memory and attention and disorientation or hallucinations.

28Specifically Standard 15.6.3 states that drivers would be eligible for a licence if they:

i. Meet the criteria for remission and/or has abstained from the substance for 12 months.

ii. Earlier re-licensing may be considered upon favourable recommendation from an addictions specialist and/or treating physician recognized by the licensing authority, and the successful completion of a drug rehabilitation program.

iii. The functional abilities necessary for driving are not impaired.

iv. Where required a road test or other functional assessment shows that the functional abilities for driving are not impaired.

29The Registrar stated that no medical information has been received to demonstrate that Standard 15.6.3 has been met. The Registrar stated that their decision is in line with the national medical standards and in keeping with road user safety.

30Section 14(2)(a) of the Regulation allows the Registrar to consider the CCMTA Standards when determining whether the requirements of s. 14(1) are met. The Tribunal may take the CCMTA Standards into consideration but are not bound by them.

31The appellant argued that he does not have a medical condition that will impair his ability to drive safely. In his Notice of Appeal and testimony, he indicated the importance of having a driver’s licence to attend work and appointments. He testified that he intends to remain sober, and he won’t be using whether it is one month or six months from now. He testified that Dr. W supported his licence reinstatement.

32As the appellant had testified as to having the support of Dr. W for driving, he was asked if he had requested a letter of support from Dr. W, but he indicated he had not. He was asked if he had spoken to his family physician about a letter of support. He testified that he is looking for a new family physician as his previous physician had not been helpful. He was asked about the duration of time he will be attending treatment services, and he indicated he does not have a date when the programs will finish.

33The appellant was asked as to driving habits and traveling to work. He responded that he was not currently working due to the fractures in his back but was hoping to get back to work in December 2025.

34Under cross-examination the appellant was asked if he had disclosed to his treating physician that he was purchasing illicit drugs, and he indicated he had. The appellant testified that the medication trazodone can sometimes mimic fentanyl in a urine drug screen and his doctor thought the positive result could be due to trazodone in the illicit drugs. After further questioning, it remained unclear, however, how this situation of the appellant using illicit opioids continued for a prolonged period of six months while under the care of an addiction treatment program, given the significant risks of using an unregulated illicit drug, particularly while concurrently being prescribed opioids.

35I considered the appellant’s position that his substance use disorder will not impact his ability to drive safely. However, this is weighed against the scientific research outlined in the CCMTA Standards that indicates opioid use results in depression of the central nervous system and can adversely affect driving performance. I have also weighed the appellant’s position against the history have having a drug withdrawal seizure and that a seizure of this nature results in complete incapacitation with an inability to compensate.

36I have also considered that the appellant has engaged with a weekly program to see an addiction physician to obtain methadone and has initiated a new addiction counseling program last month. However, I also note that despite this engagement there is no submitted medical evidence from a treating physician or healthcare practitioner that either confirms his recovery from having a substance use disorder nor provides any support for reinstatement of his driver’s licence.

37I have also considered that the appellant’s testimony regarding his intentions to remain sober. However, I find it concerning that the appellant sought out and purchased illicit drugs when he was not prescribed a sleep medication by his physician. It is concerning that he was not willing to comply with the recommendation of his physician. Furthermore, this behaviour demonstrates little insight or understanding into the risks associated with using illicit drugs, particularly while concurrently taking prescribed opioids, as well as the risk of relapse given his history of severe substance use disorder and associated seizure.

38I recognize that the appellant testified to attending appointments with a physician at True North on a weekly basis since 2023. However, I also recognize that even while engaging in the services offered at this clinic, he was purchasing illicit drugs for daily consumption for six months. The appellant’s relapse using illicit drugs while utilizing this treatment program, brings into question the efficacy of this program for the appellant.

39Although not bound by the CCMTA Standards, they can be considered when making the decision for the reason that these Standards are the result of a lengthy and intensive process to provide medical standards based on the best evidence available and with a focus on functional ability to drive rather than exclusively on medical diagnoses. I am persuaded to apply them here. My review of the evidence shows that none of the conditions recommended for relicensing outlined in the CCMTA Standards have been met.

40Given the extent of illicit drug use, the history of relapse even after the ongoing support of a weekly appointment with an addictions physician, no evidence or testimony of completing a treatment program since the latest relapse, and no submitted medical evidence from a treating healthcare practitioner that confirms recovery from substance use disorder, I find that having a period of abstinence is reasonable, as is reflected in the CCMTA guidance. With less than a quarter of the period of abstinence outlined in the CCMTA Standards elapsed, I find this insufficient to set aside the suspension in the absence of support from a treating healthcare practitioner.

41I appreciate that substance use disorders are chronic relapsing disorders that often require long term pharmacological and psychosocial interventions to prevent relapse, and the appellant has a demonstrated history of relapse. For this reason, I agree with the CCMTA Standards that require a treatment program be completed to consider early reinstatement. While the appellant has testified that he is currently involved with services to support his recovery, there is no medical evidence that he has completed any program since his latest relapse. While he has testified that there is no end date to his treatment program, I recognize these services are often several months long, and the appellant has only begun counseling at Pinewood less than one month ago.

42As such, for the reasons cited, I am satisfied on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with his ability to drive safely.

Conclusion

43I find that the Registrar has discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely substance use disorder, and that condition is likely to significantly interfere with his ability to drive a motor vehicle safely.

ORDER

44For 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.