Licence Appeal Tribunal File Number: 16711/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:

Andre Cunha

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

Panel:

Erica Weinberg, M.D., Member

Jan Dymond, Vice Chair

APPEARANCES:

For the Appellant:

Andre Cunha, Appellant

For the Respondent:

Stephen Grootenboer, Representative

Heard: by teleconference

March 11, 2025

OVERVIEW

1Andre Cunha (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (“Registrar”, 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 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 severe substance use disorder to cannabis/severe cannabis use disorder, that is likely to significantly interfere with their ability to drive safely and that this provides sufficient reason to suspend the appellant’s 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 severe substance use disorder to cannabis 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, we will address the following questions:

i. Does the appellant suffer from a medical condition, namely substance use disorder to cannabis?

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, we 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 we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.

ANALYSIS

Does the appellant suffer from substance use disorder to cannabis?

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

11The Registrar’s position is supported by a medical report completed by Dr. Tamir Streiner.

12On December 20, 2024, Dr. Streiner, a psychiatrist at Credit Valley Hospital, completed a Medical Condition Report (“MCR”) stating that the appellant suffers from substance use disorder, namely “cannabis use disorder, severe”.

13The appellant’s testimony regarding whether they suffer from substance use disorder was inconsistent. Initially, the appellant testified that they did not have substance use disorder and that they did not believe they have “severe cannabis use.” During questioning, the appellant testified to having mild substance use disorder to cannabis, whereas throughout the hearing the appellant characterized their use of cannabis as “mild” to “moderate” without characterizing his use as a disorder. They also testified that, in their opinion, they do not think they have severe cannabis use disorder.

14The appellant states that they buy their cannabis at a dispensary, do not know the tetrahydrocannabinol (“THC”) potency of their cannabis, and typically smoke 0.8 to 1.0 grams of cannabis daily. The appellant states that they smoke cannabis recreationally as well as for medical purposes, the latter to relieve sleep problems which they attribute to their sleep apnea and deviated septum.

15The appellant submits that the circumstances that led to being diagnosed with a substance use disorder are the result of an over-reaction to their cannabis use by their mother. The appellant testifies that recently they may have been smoking more cannabis than usual (i.e., more than 1.0 gram/day), and were smoking cannabis at least six times per day as they were studying for exams and not working. The appellant testified that on December 3, 2024, when their mother expressed concern that the appellant was “acting funny” and was smoking too much cannabis, their mother called a crisis support line. The appellant testifies that the police arrived and escorted them to Credit Valley Hospital where they were admitted involuntarily. The appellant initially testified that they were hospitalized for a “few days” but later, during questioning, stated that they remained in hospital for a period of approximately three weeks and that Dr. Streiner was their primary psychiatrist during their admission. When questioned further, the appellant testified that they have had three admissions to hospital for their mental health in 2024, each admission being for a few weeks.

16The appellant submits that Dr. Streiner issued the MCR as a result of a verbal “altercation” that the appellant had with Dr. Streiner on the day that the appellant was being released. They state that Dr. Streiner did not tell them they suffer from severe cannabis use disorder. The appellant testifies they do not feel Dr. Streiner had enough evidence to diagnose them with severe cannabis use disorder, that Dr. Streiner relied on the opinion of the appellant’s mother and other family members in arriving at the diagnosis, and that Dr. Streiner misdiagnosed them. The appellant testifies that they have abstained from using cannabis as of approximately three weeks prior to the hearing and have not suffered any withdrawal. They submit that the absence of withdrawal symptoms supports their position that they are not suffering from severe substance use disorder to cannabis.

17The appellant cites academic transcripts from York University and the University of Cumbria (United Kingdom) as evidence to support their position on their cannabis use, arguing that they could not perform academically if their typical substance use was severe. The appellant also testified that they stopped using cannabis while they lived in the United Kingdom for two years.

18We accept that the appellant ultimately testified that they suffer from a degree of substance use disorder to cannabis; however, it is clear from the appellant’s testimony as summarized in their closing statement “I don’t feel like my cannabis use is severe,” that they disagree that they suffer from severe substance use disorder to cannabis as stated by the respondent.

19We have considered the testimony and evidence of both parties and accept Dr. Streiner’s diagnosis of severe cannabis use disorder as being more persuasive than the appellant’s unsupported oral testimony that they do not have severe cannabis use disorder. As a psychiatrist, Dr. Streiner is qualified to make such a diagnosis. The appellant did not submit any medical evidence to dispute Dr. Streiner’s diagnosis and stated that neither their primary care physician nor their outpatient psychiatrist was currently willing to complete the Ministry’s Substance Use Assessment form, and that they made no attempts to obtain their medical records from their December 2024 hospitalization. In addition, as a licenced and duly qualified physician in the province of Ontario, Dr. Weinberg knows that persons who use cannabis for recreational purposes or for medical reasons can suffer from severe substance use disorder to cannabis. Dr. Weinberg takes notice of this fact pursuant to s. 16(b) of the Statutory Powers Procedure Act, R.S.O. 1990, c.S.22. We prefer the objective, medically supported assessment of Dr. Streiner over the appellant’s subjective self-assessment.

20Based on the above, we find that the Registrar has established on a balance of probabilities that the appellant suffers from substance use disorder, in particular severe substance use disorder to cannabis.

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

21We find that the Registrar has proven on a balance of probabilities that the appellant’s medical condition, namely severe substance use disorder to cannabis, is likely to significantly interfere with their ability to drive a motor vehicle of the applicable class safely.

22The Registrar argues that the appellant’s substance use disorder can interfere with the appellant’s ability to drive safely in that it can impair judgement, reflex control, behaviours toward others, and can delay decision making and information processing all of which could have negative consequences behind the wheel of a motor vehicle.

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 but are not bound by them.

24Section 15.4 of the CCMTA Standards (Effect on functional ability to drive) includes cannabis under its heading of psychotropic drugs and states, “The euphoric phase induced by THC affects judgement. Additional effects are time distortion, relaxation, exaggeration of sensory experiences and loss of inhibitions. The longer-lasting motor and cognitive effects affect coordination and short-term memory.”

25The Registrar relies in particular on Section 15.6.3 of the CCMTA Standards (Substance Use Disorder – All drivers) which recommends that a driver who has been found to have a substance use disorder is eligible for a licence if the driver: meets the criteria for remission and/or has abstained from the substance for 12 months; the functional abilities necessary for driving are not impaired; and, where required, a road test or other functional assessment shows that the functional abilities for driving are not impaired. Section 15.6.3. also states 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.

26The appellant testifies that three weeks prior to the hearing, and on the advice of their outpatient psychiatrist, they began abstaining from cannabis and that they will take the steps needed to have their driver’s licence restored. The appellant argues that their cannabis use does not impact their ability to drive safely. They testify that they are aware of the risks of driving while impaired and do not drive for several hours after smoking cannabis.

27Although we are not bound by the CCMTA Standards, we find them to be reasonable. They state that the use of cannabis can impair a driver’s judgement and behaviour towards others, including a driver’s ability to judge whether they are fit to drive or not. Although a person may, when not under the influence of cannabis intend not to drive when intoxicated, their assessment of their ability to drive will likely be affected by having consumed cannabis.

28Although Section 15.6.3 of the CCMTA Standards states that its application is with respect to alcohol and illicit drugs, and while the use of cannabis for recreational purposes is legal in Canada and therefore not “illicit,” we find the CCMTA Standard 15.6.3 to be relevant to the condition of substance use disorder to cannabis. The relevant characteristic of cannabis for the purpose of this appeal is not whether the substance is illicit but whether the substance has a negative impact on a person’s ability to drive safely, which we have found that cannabis does.

29We also take note that section 15.6.4 of the CCMTA Standards (Alcohol, Cannabis and Driving – All drivers) states that cannabis is known to impair the ability to operate a motor vehicle safely. It recommends that, in general, individuals should not drive for approximately 5 hours after consuming medical marijuana (cannabis) and not drive at all if consuming 3 or more joints a day.

30For the following reasons, we find, on a balance of probabilities, that the appellant’s severe substance use disorder to cannabis is likely to significantly interfere with their ability to drive a motor vehicle of the applicable class safely.

31Section 6.8.2 of the CCMTA Standards highlights the importance of a driver’s level of insight into their condition. This is because drivers with good insight are more likely to be diligent about their treatment regime, to seek medical attention when needed, and to avoid driving when their condition is likely to impair their functional ability to drive. An individual’s level of insight is a critical consideration when assessing the risk of an episodic impairment of functional ability due to a psychiatric or mental health disorder, such as substance use disorder.

32Based on the evidence before us, we find that the appellant currently lacks sufficient insight into their substance use disorder to cannabis.

33The appellant currently does not acknowledge or accept that they suffer from severe substance use disorder to cannabis; testified that following their discharge from hospital in late December 2024 they began using cannabis again at their usual amount/frequency, and did not alter their cannabis consumption immediately following the suspension of their driver’s licence.

34As referenced above, the use of cannabis can interfere with functions necessary for the safe driving of a vehicle, including good judgement. The fact that until beginning to abstain from cannabis use three weeks ago, the appellant would drive a motor vehicle within a few hours of using cannabis suggests that their insight is lacking since they are relying on their own judgement as to whether they are too impaired to drive.

35We accept the appellant’s testimony that they currently are abstaining from cannabis use; however, we find on a balance of probabilities that their current commitment to abstention appears to be transactional in order to regain their licence rather than grounded in an awareness they suffer from severe substance use disorder to cannabis that requires ongoing management on their part.

36Although we are optimistic and encouraged by the return to driving plan the appellant has with their outpatient psychiatrist, given the circumstances of this case we find that three weeks of abstinence from cannabis is too early to consider reinstatement of the appellant’s driver’s licence. Moreover, the appellant does not currently have written or expressed oral support for their return to driving from any healthcare professional, including their family physician and their outpatient psychiatrist.

37We are satisfied on a balance of probabilities that the appellant’s medical condition is likely to significantly interfere with their ability to drive safely.

Conclusions

38We find that the Registrar has discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely severe substance use disorder to cannabis, that is likely to significantly interfere with their ability to drive a motor vehicle of the applicable class safely.

ORDER

39For the reasons set out above, pursuant to subsection 50(2) of the Act, we confirm the Registrar’s decision to suspend the appellant’s driver’s licence.