Re: Alexander M. Wheeler
ORB File No: 7078
Hearing held on: Friday, October 10, 2025
Place of hearing: St. Joseph's Healthcare Hamilton West 5th Campus, 100 West 5th Street
Pursuant to: Section 672.82(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. S. Clapp
Members: Dr. H. Bloom Dr. A. Kerry Mr. P. Capelle Mr. S. Doherty
Parties Appearing:
Accused: Alexander M. Wheeler Counsel: Mr. A. Rai
The Person in charge of Hospital: Counsel: Ms. L. Barney
Attorney General of Ontario: Counsel: Ms. C. Gzik
REASONS FOR DISPOSITION
(Dated November 24, 2025)
Introduction
On December 23, 2016, Mr. Alexander M. Wheeler was found not criminally responsible on account of mental disorder on charges of assault with a weapon, utter a threat to burn, destroy or damage a property, criminal harassment, and utter a threat to cause death or bodily harm, all contrary to the Criminal Code of Canada (the "Criminal Code"). Mr. Wheeler is currently subject to a Disposition of the Ontario Review Board (the "Board") dated November 20, 2024, detaining him at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton (“St. Joseph's”), with privileges up to living in the community of Southern Ontario in accommodation approved by the person in charge.
On October 10, 2025, a panel of the Ontario Review Board (the "ORB" or the "Board") convened a hearing pursuant to s. 672.82(1) of the Criminal Code. Mr. Wheeler was in attendance for most of the hearing and was represented by his counsel, Mr. Rai. Mr. Wheeler and his father left the hearing when a break was taken after approximately 1.5 hours and did not return.
Without Prejudice Position of the Parties
Ms. Barney, on behalf of the hospital, recommended a renewal of the existing detention disposition, as set out at page 79 of the October 7th 2025 Hospital Report, entered as Exhibit 1, reproduced below for ease of reference.
The hospital concurs with the opinion of the treatment team and recommends continuation of the current Detention Order with the same terms and conditions as the November 20, 2024 order.
Ms. Gzik, for the Attorney General, supported the hospital’s recommendation.
Mr. Rai, on behalf of Mr. Wheeler, indicated that an absolute discharge was sought. In the alternative, if the threshold for significant threat is determined to have been met, Mr. Rai sought a conditional discharge which includes the following terms/conditions:
s. 672.55 consent to treatment provision,
Young clause for assessment and readmission.
residency specification to: 13482 Tenth Line, Georgetown, ON.
Background and Index Offences
This was an Early Review (Board/Party) NCR hearing preceded by two Ontario Court of Appeal (ONCA) decisions, the latter of which ordered an early review before a newly constituted panel of the Board for a second time:
Reasons for Decision Wheeler (Re), 2024 ONCA 726, heard on– Sept. 12, 2024
Reasons for Decision Wheeler (Re), 2025 ONCA 594, heard on– May 27, 2025
Mr. Wheeler is a 39 year old single man. His brother and mother have passed away. He has a half-sister and a half-brother, and currently lives with his father. He left home when he was in grade 11, and concerns about his substance use and mental health were noted at that time. He eventually completed high school by attending night classes, and also obtained some college credits in construction management. Mr. Wheeler worked in labour and construction and as a heavy machinery operator. His criminal history includes some Youth Court charges in 2003-2004, and one prior assault charge in 2006.
Mr. Wheeler had a number of psychiatric hospital admissions between 2011 and the index offences in 2016. He was frequently diagnosed with Schizoaffective Disorder, and cannabis use and noncompliance with medication were also noted. Prior to the index offences, Mr. Wheeler was living alone and not working. He had been using cannabis regularly for several years, and also experimenting with other substances including crystal methamphetamine.
A summary of Mr. Wheeler’s history under the jurisdiction of the Board is taken from last year’s Reasons for Disposition (which were taken from the ONCA 2024 Decision), as follows:
“From July 2018 to October 2023 the appellant lived in the community, although he was voluntarily readmitted to hospital a number of times. He received a conditional discharge on February 19, 2020. Shortly thereafter he began to test positive for cannabis, and did so for much of that year. He was voluntarily readmitted to hospital between November 17 and December 9, 2020 to help curb his use of cannabis. Together with his treatment team, the appellant began a “harm reduction” approach. In April 2022, the appellant moved to his father’s home where he helped him with chores on the large property.
In October 2023, the appellant was readmitted to the hospital due to his ongoing cannabis use. His treatment team noted some changes to his mental state around this time. On December 7, 2023, a restriction of liberty hearing was held, at which time the Board changed his disposition to a detention order, with privileges up to and including living in the community in approved accommodation, as well as passes for up to seven days indirectly supervised in the community of southern Ontario. The appellant’s annual review was held on March 5, 2024, at which point a different panel of the Board concluded that he remained a significant threat to the safety of the public and that a detention order was the least onerous and least restrictive disposition to manage the risk.”
The circumstances of the index offences are taken from last year’s Reasons for Disposition as follows:
“On July 3, 2016, the accused stated he was going to “smash” his brother’s skull with a “beating stick from the OPP”. Given his increased erratic behaviour up to that point, the accused’s brother feared that the accused would act on his threat.
Between July 17 and July 28, 2016, the accused threatened his father that he would “burn” his dwelling house down.
On July 31, 2016, the accused arrived at his brother’s residence in a vehicle made to resemble a police cruiser and attempted to arrest his brother. In so doing, he held his hands behind his back and the brother feared that he was in possession of a weapon. The accused grabbed a stick and unsuccessfully tried to jab his brother. He then threw a piece of broken asphalt at him which the brother avoided. The accused went to his vehicle and said, “I have guns”. At that point his brother ran to safety.
When police apprehended the accused, in his trunk they found a fully operational airsoft rifle resembling a military style AR-15 assault rifle.
Notwithstanding the accused’s brother and father telling the accused to stay away from their home, he showed up at their residence in the early morning hours waking his father and brother. On July 28, 2016, he again showed up and was advised by the police not to return to the property unless the father gave permission.
On July 31, 2016, the accused showed up again at the residence and he attempted to ‘arrest’ his brother, as above noted.
Another visit was made by the accused to the residence on August 19, 2016, honking his horn repeatedly. Once again, he was apprehended by the police, and they found him to be in possession of a paintball gun."
Current Diagnoses
Schizoaffective Disorder, Bipolar Type
Cannabis Use Disorder
Evidence at Hearing
Dr. Naidoo was called to give evidence for the hospital. He has been Mr. Wheeler's attending psychiatrist since 2017/2018. He testified having read and adopted the contents of the Hospital Report.
Mr. Wheeler is on a positive trajectory. He was discharged from hospital on September 20, 2025, to reside in the community with his father, subject to a twice-weekly reporting requirement.
While in hospital, Mr. Wheeler had interacted well with staff and behaved appropriately during accompanied group outings. He has remained treatment capable, “fully adherent to treatment” and open to changes to his prescribed medications. He used passes to visit his father in Georgetown that went well, and there was no indication that he had not taken his medications.
Ten years ago, Mr. Wheeler was a heavy equipment operator and business owner, and he retains a strong desire to work in this field. However, Dr. Naidoo testified that since taking over Mr. Wheeler's care his patient has never been employed. This lack of structure is identified as a risk factor.
In June 2025, a discussion was initiated to change Mr. Wheeler's psychotropic medication from Haldol to Abilify to decrease side effects and potentially reduce his craving for cannabis. During the transition, some instability was noted by Dr. Naidoo as well as members of the treatment team. This demonstrated that ongoing monitoring in the presence of a destabilizing element, such as cannabis, is required to guard against symptoms of destabilization such as sleep difficulties, pressured speech and persistent agitation. Impulsivity and rule adherence are not day-to-day concerns when Mr. Wheeler is at his baseline.
Mr. Wheeler understands he has a chronic mental illness that requires treatment, and he recognizes the symptoms and early warning signs. However, his grasp of the impact of cannabis use on his risk of violence is sub-optimal. He is externally motivated to remain abstinent. His last positive screen for cannabis was in April 2025. There was no change in Mr. Wheeler’s presentation at that time, and he was not irritable or hypomanic. He is now considered to be in early remission, however he needs to be monitored closely now that he is living in the community and has more access to cannabis. He is not prescribed any medication to reduce his cravings for cannabis. Mr. Wheeler's risk is primarily attributable to substance abuse and his limited insight vis-à-vis its destabilizing effect.
If granted an absolute discharge, he has a family physician in Georgetown who could theoretically prescribe his psychiatric medications. There is also a psychiatrist linked to Mr. Wheeler’s family doctor, but no connection has been made to date. Dr. Naidoo did not have concerns about prescription of the medication and stated that Mr. Wheeler has always been open and willing to engage in treatment and he had always been adherent. Dr. Naidoo’s concerns related to the absence of monitoring of symptoms such as impulsivity, and substance use, and a related deterioration in insight leading to non-compliance. Prior to the index offences, Mr. Wheeler discharged himself from an ACT team, fell away from medications and was using both cannabis and methamphetamines when the index offences occurred some five months later. As such, Dr. Naidoo remains concerned about Mr. Wheeler's adherence to treatment, absent the support of a robust care team to prevent substance use. If he uses cannabis, his insight will deteriorate and he will not remain adherent to his prescribed psychotropic medications.
Dr. Naidoo opined that if Mr. Wheeler was granted an absolute discharge his risk would increase via the use of higher potency cannabis and increased frequency of use. This would result in mental decompensation, followed by threats against individuals who he believes were restricting his liberties, most likely his father. Others at risk would include friends whom he perceived as curtailing his liberties. For example, if he delusionally believed a friend contacted the hospital to try and have him readmitted.
A conditional discharge was considered although Mr. Wheeler has only recently been discharged from hospital. If he relapses to cannabis use, which is highly likely, he will require rapid readmission. When he was previously subject to a conditional discharge there were several attempted but thwarted re-hospitalizations which relied on the provisions of the Mental Health Act because the civil standard of committal enabling inpatient detention were not met, and he was not willing to stay in the hospital. Without the ability to admit Mr. Wheeler to the hospital there is no way to curtail his use of cannabis and mitigate his risk. Dr. Naidoo acknowledged that Mr. Wheeler has cooperated and returned to the hospital at times, but not recently.
Prolonged oversight within the forensic system has frustrated Mr. Wheeler. There was a period of three years under the Board when Mr. Wheeler did not use cannabis. He now refuses to re-engage in substance use programming which he previously completed and did not find beneficial. Dr. Naidoo opined that adding additional interventions could prove counterproductive. He also stated that Mr. Wheeler's risk is almost certain to increase via the use of higher potency cannabis and increased frequency of use as a result if his active addiction and peer group.
Ms. Gzik inquired who Mr. Wheeler's father would reach out to if he suspected cannabis use by his son. Dr. Naidoo advised that this would be Mr. Wheeler's case manager. The doctor added that despite education provided to Mr. Wheeler's father, this gentleman lacks a robust understanding of the degree of risk associated with the under reporting of symptoms. Mr. Wheeler's father views the hospital as an institution that continues to restrict his son's liberty for using legal recreational drugs. Nonetheless, Mr. Wheeler's father wants to support his son, and has recently prohibited individuals from using cannabis at his home. While this has not occurred before, Dr. Naidoo expressed concern that Mr. Wheeler may not respect his father’s request. Dr. Naidoo could not say with certainty that Mr. Wheeler's father would report instances of cannabis use by his son, although he would report if his son became “quite unwell”, and has done so in the past. Mr. Wheeler's half-sister became an approved person in June of 2025 and Dr. Naidoo expressed confidence that she would report signs of changed mental state to the treatment team. She lives in the Halton area and has contact with her half-brother several times per week.
Ms. Gzik inquired if there is an amount of cannabis that Mr. Wheeler could safely use in keeping with Canada’s Low-Risk Cannabis Use Guidelines. Dr. Naidoo responded that there was not for someone with Mr. Wheeler's diagnosis, particularly given the concern that he would seek higher potencies and higher doses.
Responding to questions from Mr. Rai, Dr. Naidoo confirmed, the following entries to the Exhibit 1 Hospital Report:
2020, voluntary admission and compliant with medication (page 28),
2021, July 20 – August 4, voluntarily admitted and compliant with medication (page 38),
2022, November 6, voluntarily admitted and medication compliant (page 42),
2023, July admission, patient medication compliant at time of admission,
2023, September admission, patient medication compliant at time of admission,
2023 October admission, patient medication compliant at time of admission.
Dr. Naidoo conceded that Mr. Wheeler remained medication compliant during all six of the above noted admissions and he did not exhibit any aggressive or violent conduct.
Mr. Rai then drew Dr. Naidoo's attention to events from 2024 referenced at pages 53, 63 and 72 of the Hospital Report ,which respectively indicate:
January 12 &13, positive urine drug screens (“UDS”) for cannabis,
March 27, July 29, and August 7 presumptively positive UDS for cannabis
November 27, presumptively positive UDS for cannabis, privileges cancelled.
Dr. Naidoo conceded that during all the above noted 2024 events, Mr. Wheeler was medication compliant, never violent, never assaultive, and never verbally aggressive.
Dr. Naidoo further conceded that as indicated at page 73 of the Hospital Report, on April 28, 2025, Mr. Wheeler’s UDS returned positive and his privileges were cancelled. Again, Mr. Wheeler was never violent, assaultive or verbally aggressive to staff or members of the public and remained medication compliant. This was also the case for an earlier positive UDS for cannabis in 2025.
Dr. Naidoo agreed with Mr. Rai’s suggestion that his patient is/has:
not psychotic,
no active delusions,
not voicing an intent to harm himself or others,
index offences date back to 2016, and involved threatening his father and brother, trying to arrest them, throwing a piece of asphalt, having a paintball gun in his car,
not taking psychotropic medications at time of the 2016 index offences,
using cannabis and methamphetamines at the time of the 2016 index offences,
no incidents of violence since 2016,
no new criminal charges since 2016,
treatment capable,
manages his psychotropic medications independently,
all psychotic medications ingested by mouth,
no concerns with medication adherence now or ever while under the Board,
never stated he wants to stop his prescribed medications,
he has made efforts to decrease his cannabis use,
responded well to the June 2025 changeover from Haldol to Abilify and says that he feels better on Abilify.
Mr. Rai referenced page 78 of the Hospital Report which indicates that on September 9, 2025 after transitioning Mr. Wheeler to Abilify in June 2025, the patient himself noted erratic speech, impaired sleep initiation and increased irritability which responded well to PRN medication. Dr. Naidoo conceded that this was the same day Mr. Wheeler was upset about the disclosure of his forensic mental health status to a potential employer. Dr. Naidoo added that similar symptoms were reported a “handful” of times before and after that date, none of which would be considered symptoms of significant instability, although suggestive that continued monitoring was needed together with medication review. Dr. Naidoo added that these symptoms did not delay discharge planning which occurred 11 days later. There have been no incidents of concern following Mr. Wheeler's September 20, 2025 discharge to his father's home, other than two minor incidents which involved Mr. Wheeler not telling the team about cash work for a neighbour in the context of the hospital’s potential need to disclose Mr. Wheeler’s ORB status. Mr. Wheeler has cooperated with respect to this issue since then.
Mr. Rai asked Dr. Naidoo if he had read the two Court of Appeal judgements pertaining to Mr. Wheeler. Dr. Naidoo responded that paragraph 36 from the May 2025 Decision states that the hospital was to meaningfully explore the issues identified.
In the context of Mr. Wheeler’s ongoing medication compliance, Mr. Rai asked Dr. Naidoo to address the first sentence of paragraph 13 of the ONCA’s 2025 decision in Wheeler (Re), 2025, ONCA 594, reproduced below for ease of reference:
[13] We agree that neither Dr. Naidoo in his evidence nor the Board in their analysis grappled with this court’s directive that they explain how “the appellant’s continued use of cannabis would create a substantial risk of serious harm to the public” and how “the final step in Dr. Naidoo’s cascading risk scenario was supportable on the evidence as a whole.”
Dr. Naidoo responded that he relies on the bar set by the index offences which brought Mr. Wheeler into the forensic system, then added that the bar to get out can be higher. Mr. Wheeler impulsively threw a chunk of concrete at his brother, which could have caused a life-threatening injury. Dr. Naidoo added that the relevancy and connection of cannabis use to causation is at play.
Dr. Naidoo referenced page 78 of the Hospital Report, second paragraph, wherein he addresses Mr. Wheeler's tendency to use cannabis and predisposition towards higher potency. This translates to short lived admissions under the Mental Health Act. Mr. Wheeler likes high strain cannabis (poppers), adding that this preference is a sign of addiction. Dr. Naidoo stated that cannabis can be quite toxic for the fraction of the population with mental illness. He again referenced page 78, which indicates that cannabis use doubles the risk of violence in schizophrenia spectrum illnesses. Dr. Naidoo testified that it is not an exact science whether cannabis use will lead to violence, but he was relying upon the best available evidence and theoretical literature (cohort level evidence) that correlates cannabis use and violence. In Mr. Wheeler's case, the time points when he had no oversight to break the cycle of use occurred when he was untreated in 2016. Dr. Naidoo added that there is some evidence that medication is less than likely to mitigate the risk of cannabis use.
The index offences are the time point where cannabis use precipitated violence. An already vulnerable patient is therefore likely to be at higher risk of violence when using cannabis. The missing link is identifying the protective effect of medication. Dr. Naidoo stated that there has not been extensive research on the impact that cannabis has on psychotropic medications.
Even absent cannabis use and when medicated, Mr. Wheeler has exhibited some instability. When readmitted in 2024 following cannabis use, he exhibited hypomanic symptoms. Destabilization was limited by the quick intervention of the treatment team to re-hospitalize Mr. Wheeler. This stopped his ongoing cannabis use and the use of higher strains of cannabis, thereby preventing instability and violence in the context of his mental illness. Unchecked cannabis use was linked to violence in the course of Mr. Wheeler’s index offences.
Dr. Naidoo stated there were times when Mr. Wheeler consumed low THC potency cannabis which went undetected. Dr. Naidoo added that Mr. Wheeler was likely trying to avoid detection and not using the higher potency strains that he prefers. Mr. Wheeler currently submits twice weekly to UDS testing. A panel member inquired if the UDS testing provides results for other cannabinoids such as CBG, CBN and CBD. Dr. Naidoo responded that testing does not reveal the presence of those related cannabinoids.
Dr. Naidoo stated that if the Board ordered an absolute discharge, he would not abandon Mr. Wheeler. Dr. Naidoo would update Mr. Wheeler’s family doctor and attempt to connect him to an outpatient team and psychiatrist, although he would not retain the support of a forensic treatment team.
Dr. Naidoo stated that for vulnerable individuals like Mr. Wheeler, cannabis use can have a deleterious effect. He agreed with the following statement at page 78 of the Hospital Report:
Hence, cannabis is highly likely to be an exacerbating factor for Mr. Wheeler’s illness and for subsequent violence of a similar magnitude to that of the index offence.
Dr. Naidoo testified that cannabis use reduces motivation for Mr. Wheeler while his patient disagrees. Mr. Wheeler does not see any deleterious or negative effect of cannabis on him personally and has expressed that the restrictions placed on him by the Board have held him back. Mr. Wheeler’s primary method of cannabis use is smoking.
Mr. Wheeler sees cannabis use as part of the work culture in the construction industry. Dr. Naidoo opined that use of cannabis would impair Mr. Wheeler's use of large machinery, the same way that it would impair his ability to operate a motor vehicle. Asked if Mr. Wheeler appreciates the risk of harm associated with the use of heavy equipment, Dr. Naidoo responded that he does not because he speaks of the culture that exists on a construction work site.
Later in his testimony Dr. Naidoo stated Mr. Wheeler should be safe to operate heavy equipment at this time although his history indicates he will use substances again. Monitoring has helped in the past. Dr. Naidoo stated he is hopeful and optimistic that Mr. Wheeler will not use in future noting that his patient is currently being tested two to three times per week.
Dr. Naidoo testified that at the time of the index offences Mr. Wheeler's father lived in a constant state of fear and this now seems to have changed notwithstanding that Mr. Wheeler has said that he will invite individuals to his father’s home that will want to use cannabis. The doctor opined that Mr. Wheeler's father could not deter these types of activities because his son would not respect his wishes to bar those individuals from the property. Additionally, Dr. Naidoo described Mr. Wheeler's father's level of insight as somewhat limited because he believes that his son has been in the forensic system for too long and that the terms and conditions imposed on his son are overly onerous. Mr. Rai referenced page 57 of the Hospital Report which indicates that Mr. Wheeler's father does not allow him to use substances at home. Dr. Naidoo stated this entry was correct although driven by the social worker’s presence at his home.
Dr. Naidoo agreed with a panel member’s suggestion that it is well established that the use of intoxicants exacerbates the likelihood of risk in patients with psychotic disorders. Dr. Naidoo added that Mr. Wheeler smokes cannabis both alone and socially. He struggles to set limits on his use with social contacts. He obtains cannabis from individuals on hospital grounds, from friends and from dispensaries. Dr. Naidoo takes no comfort if Mr. Wheeler obtains his cannabis from a licensed source as the primary concern is potency of the THC.
Dr. Naidoo had no reliable sense of how much cannabis Mr. Wheeler was using and how frequently he used. Asked how much cannabis Mr. Wheeler would use if unfettered by restrictions, Dr. Naidoo stated that this last occurred in 2016, prior to the commission of the index offence. Therefore, he cannot provide an estimation at this time. At present, Mr. Wheeler believes cannabis can be used safely with psychotropic medications on board. Therefore, the doctor's concern remains the increasing amount and potency of the cannabis his patient would use. Dr. Naidoo added that there is no evidence regarding Mr. Wheeler's cannabis tolerance levels because he was readmitted to hospital when he tested positive, and he reiterated that his patient struggles to set limits on his use.
Dr. Naidoo opined that while Mr. Wheeler’s declaration that he would like to abstain from cannabis is at times sincere, it is largely externally driven to keep him out of hospital and to maintain his driver’s licence. Mr. Wheeler has mentioned many times that his long-term goal does not include abstinence from cannabis and his actions have been in line with that. Mr. Wheeler describes his cravings as overwhelming. The use of Gabapentin and anxiolytics have not been successful. Acetylcysteine, an anti-anxiety medication has also been considered; however, it is an expensive medication not covered by his drug plan. The concern remains that Mr. Wheeler wants to work, drive and live with his father while consuming cannabis.
Abstention from cannabis will facilitate Mr. Wheeler getting back to work and helping his father. Mr. Wheeler understands that psychotropic medications manage the mood symptoms of his illness. His insight however surrounding symptoms of psychosis and delusional beliefs is more limited, and the destabilizing effect of substances even more so.
Mr. Wheeler has told Dr. Naidoo that he has used poppers more than once and that he previously used low dose cannabis to avoid detection.
Dr. Naidoo was asked what evidence he was relying upon that Mr. Wheeler will use cannabis unfettered. He responded that the only time this has occurred was prior to the index offences, because since then he has been subject to the external controls of the Board. According to Dr. Naidoo, impulsivity is a symptom of both mania and hypomania which can lead to increased cannabis use. Mr. Wheeler has self-reported that he cannot control his cannabis use at times.
As a result of poor impulse control, Mr. Wheeler has tended to use higher potency marijuana which is likely to continue absent oversight. He will admit at times that he cannot manage his impulse to use but struggles to accept this. Dr. Naidoo was asked again if his patient were to use cannabis in an unfettered fashion how long it would take for symptoms of his mental illness to emerge. Dr. Naidoo responded that if his patient was using a higher dose of cannabis, it could be one to two days. Were he using a lower dose, perhaps two weeks.
Mr. Wheeler has previously been open to be followed by ADAPT; an outpatient addiction, assessment and treatment agency, but this is no longer the case. He will state that groups like Narcotics Anonymous are now triggering for him. He has indicated that he would be open to engaging with a family physician and accepting of a psychiatric referral in the event he was granted an absolute discharge. Mr. Wheeler wants to employ a harm reduction approach which was previously tried unsuccessfully using CBD and low potency THC. When asked how the team became aware of Mr. Wheeler using over and above the low-risk guidelines, Dr. Naidoo stated that Mr. Wheeler was forthcoming about his use.
Dr. Naidoo opined that if granted an absolute discharge Mr. Wheeler is unlikely to remain abstinent from substances, rather his use will increase and it is an inevitability that he will again pose a risk of serious psychological or physical harm to members of the public.
When Mr. Wheeler had previously resided in the community in 2022 to 2023, he was in a relationship that was somewhat destabilizing, was using cannabis, and his days lacked structure. In that context, there was no verbal or physical aggression. Mr. Wheeler lived closer to the hospital at that time and had frequent contact with the treatment team. Dr. Naidoo was asked what factors would enable him to recommend a conditional discharge rather than a detention disposition for Mr. Wheeler. He reiterated that his patient’s singular risk factor is cannabis use. Therefore, Mr. Wheeler must show the ability to maintain his abstinence from cannabis prior to consideration of a conditional discharge.
Mr. Wheeler’s history is that he does want to come to/remain in hospital. It has proven difficult to bring and keep him in hospital using the provisions of the Mental Health Act. Living with his father, Mr. Wheeler is likely to exhibit symptoms of his mental illness which is why a detention disposition is recommended.
A Young clause within a conditional discharge would not assist because his judgment would be impaired and he would not want to return to hospital from Georgetown, a significant distance.
Dr. Naidoo was asked why Mr. Wheeler's taking of antipsychotics on a consistent basis does not diminish his risk. Dr. Naidoo responded that the largest observational study is that an individual taking a non-clozapine medication will not remain protected from the use of cannabis. Mr. Wheeler has exhibited changes to his mental state absent the use of cannabis. Recent medication changes, although not yet stabilized, have reduced his urge to use cannabis. As he is not yet stable on Abilify, he remains particularly vulnerable.
Closing Observations
Ms. Barney stated that the hospital was seeking a detention disposition which includes the entitlement of community living. Mr. Wheeler continues to present a significant threat due to cannabis use that in the absence of a detention disposition will become unfettered in frequency and potency leading to decompensation and behaviour similar to what was seen at the time of the index offences. She urged the panel to consider Dr. Naidoo’s responses, particularly his responses to the questions posed vis-à-vis causation.
Ms. Gzik submitted that Canada’s lower-risk cannabis use guidelines are directed at the general public, and abstention is the only way to prevent the harm that Mr. Wheeler will cause if he uses. There remains evidence of significant threat to members of the public including to Mr. Wheeler’s father, notwithstanding that his father is now supportive of his son. She added that Mr. Wheeler has not demonstrated a full and complete commitment to abstinence. Therefore, a detention disposition remains necessary and appropriate.
Mr. Rai submitted that the relevant question is whether Mr. Wheeler's use of cannabis in the context of medication compliance and stability constitutes a significant threat of physical or psychological harm that is beyond trivial. He submitted that the answer is no. Over several admissions and positive UDSs, Mr. Wheeler has always remained compliant with medication by choice, non-violent, non-aggressive, non-threatening, and non-assaultive. At the time of the index offences nine years ago, he was unmedicated and using both cannabis and methamphetamines. Since that time, he has been entirely free of violence, with no new criminal charges, and remained consistently capable and medication compliant. In the summer of 2025, when switched to Abilify, Mr. Wheeler reported feeling better, more alert and less euphoric. The symptoms of decompensation reported in September coincided with the period associated with frustration regarding disclosure of his mental status to a potential employer.
Mr. Rai referenced paragraph 16 of ONCA’s September 12, 2024 reasons in Wheeler (Re), 2024 ONCA 726, reproduced below for ease of reference:
[16] It may be that the appellant’s continued use of cannabis will exacerbate the symptoms of his mental illness. However, the question the Board had to consider was whether this presented a foreseeable and substantial risk of physical or psychological harm to members of the public, based on a scenario in which the appellant committed serious criminal conduct resulting in harm that is “serious and beyond the trivial or annoying”: Ferguson, at para. 8. We are unable to discern from the Board’s reasons how the Board concluded that this test was met.
Mr. Rai concluded his remarks by emphasizing that the Board’s jurisdiction is not to enforce abstinence but to protect the public from significant harm, and that threshold is a high one. He submitted that the whole time Mr. Wheeler has been under the jurisdiction of the Board and compliant with medication, there is no evidence that he has been a threat. Paragraph 10 of the ONCA’s May 27th 2025 reasons in Wheeler (Re), 2025, ONCA 594, reiterates the request for an explanation to the question articulated in that Court’s reasons from September of 2024. Mr. Rai submitted that while Mr. Wheeler’s cannabis use may be clinically frustrating it does not constitute a significant threat per Winko v. British Columbia. As a result, Mr. Wheeler is entitled to an absolute discharge.
Analysis and Decision
Ongoing significant threat to the safety of the public cannot be speculative or uncertain. It must entail a real risk of serious physical or psychological harm arising from conduct that is both serious and criminal in nature. There must be a positive finding of a significant risk to the safety of the public to engage the provisions of the Criminal Code and to support restrictions on a NCR accused’s liberty.
In determining whether Mr. Wheeler continues to represent a significant threat to the safety of the public the Board has carefully analyzed the evidence as it relates to the Supreme Court of Canada decision in Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.
The Board unanimously finds that Mr. Wheeler no longer poses a significant threat to the safety of the public. In arriving at this determination, the Board considered the hospital’s recommendation, supported by the Attorney General, as well as the Record Items/Exhibits and the expert evidence of Dr. Naidoo.
The position advanced on behalf of Mr. Wheeler, unanimously accepted by this panel following an independent analysis, is that Mr. Wheeler is entitled to an absolute discharge because he no longer meets the requisite threshold for significant threat.
The hospital’s position is that there is a singular risk factor for Mr. Wheeler at this time, the use of cannabis. The 2016 index offences occurred at a point in time when there was no oversight of Mr. Wheeler’s use of that substance. According to Dr. Naidoo, the presumed trajectory towards mental decompensation that would put individuals at risk is as follows:
absence of forensic oversight,
use of higher potency cannabis,
increased frequency of cannabis use,
mental decompensation,
deterioration of insight,
treatment non-compliance,
threats against individual perceived as restricting his liberties,
serious physical or psychological harm to a member of the public.
It is this trajectory that the Board was required to carefully examine in order to determine whether Mr. Wheeler remained a significant threat to the safety of the public. The panel considered the evidence related to each step, and ultimately concluded that the trajectory or “cascading risk scenario” (as characterized by the Ontario Court of Appeal) was not supportable on the evidence as a whole.
To begin, there was no dispute that Mr. Wheeler has been fully compliant with antipsychotic medication since he came under the jurisdiction of the Board, and that he has not shown symptoms of psychosis or delusions while taking medication. Dr. Naidoo testified that Mr. Wheeler “has always been open and willing to engage in treatment and he had always been adherent.” This has been the case since the summer of 2016 when the index offences occurred and continues to the present. Mr. Wheeler is capable of consenting to treatment, is responsible for the administration of his own oral medications, and has never stated that he intends to stop them.
This positive predisposition is documented most recently in June 2025, during Mr. Wheeler’s transition from Haldol to Abilify. While some instability was noted in Mr. Wheeler’s affect, Dr. Naidoo testified that his patient remained able to discuss his symptoms, request PRN medication and by the next day had returned to baseline. Similarly, by September 2025, once the medication transition had been completed, Mr. Wheeler self-reported some symptoms that again responded well to PRN medication. This incident coincided with the mandatory disclosure of Mr. Wheeler’s ORB status to a potential employer which upset him. As noted at page 78 of Exhibit 1 these symptoms did not negatively affect community discharge planning to Mr. Wheeler’s father’s home 11 days later.
The first step in the trajectory above is that Mr. Wheeler is likely to use cannabis in increasing potencies and frequency absent the oversight of the Board. While the evidence was clear that Mr. Wheeler is likely to use cannabis, it was not clear that he would likely use in increasing potencies and frequency. There have been times where Mr. Wheeler has been abstinent from cannabis while living and working in the community (2018-2019), times when he used cannabis while living in the community on a Conditional Discharge or Detention Order (2020-2023) (it was noted that at times he used increasing amounts and other times he used within the low risk guidelines), and times when he used cannabis and requested a voluntary admission or agreed to stay voluntarily for a period of time (November 2020 and November 2022). It was also noted that Mr. Wheeler experienced significant stressors during some of these times, including ongoing conflict with a partner, and the deaths of family members. While the Hospital Report referenced Mr. Wheeler using high potency cannabis at times, it was not something that occurred regularly, and the treatment team knew about it because Mr. Wheeler had been open about it. There was also evidence that Mr. Wheeler wanted to work and maintain his driver’s licence, which were motivating factors to reduce or abstain from cannabis use. For these reasons the panel was not satisfied that the evidence supported the conclusion that Mr. Wheeler was likely to use unfettered amounts of cannabis.
The next steps in the trajectory are mental decompensation, deterioration in insight, and non-compliance with treatment. In Mr. Wheeler’s case, the evidence established that throughout the periods where Mr. Wheeler was using cannabis (even the high potency cannabis), his mental status was consistently described as stable and there was no evidence of elevated mood or delusional beliefs. The most that was recorded was hypomania with irritability, grandiosity, and pressured speech (noted prior to Mr. Wheeler’s readmission to hospital in October 2023 following a number of positive UDS tests for cannabis and resulting short admissions). The panel also noted that Mr. Wheeler’s baseline presentation with the treatment team was often oppositional, frustrated, and irritated. There was also no evidence that Mr. Wheeler’s insight into his illness or the need for medication had changed. He remained fully compliant with prescribed medications and the expectations of the treatment team. The only time that this cascade of events had occurred was at the time of the index offences, and that was also when Mr. Wheeler was not taking medication and was using both cannabis and crystal methamphetamine. It has not occurred since then, even when Mr. Wheeler has used cannabis.
The final step in the trajectory is that Mr. Wheeler’s continued use of cannabis will ultimately lead to a substantial risk of serious physical or psychological harm to the public. There was no dispute that Mr. Wheeler has not been threatening, aggressive, assaultive, or violent since the index offences, even during the times when he was using cannabis and living in the community. It was also noted that Mr. Wheeler does not have a history of assaultive or violent behaviour despite interactions with police in the past, and a 2006 domestic assault charge (for which no details were provided). Although Dr. Naidoo relied on the studies (which he acknowledged are somewhat limited) that are available on the issue of cannabis use and risk of violence in people with psychotic disorders, as well as whether antipsychotic medication has a mitigating effect on the risk of cannabis use, the panel was required to focus on Mr. Wheeler’s specific history and circumstances. There was simply no evidence that Mr. Wheeler’s cannabis use had affected his mental status such that the symptoms of his mental illness reached the threshold required in order to find significant threat. It is recognized that this is in the context of Mr. Wheeler’s sustained and consistent compliance with antipsychotic medication, which as was discussed above, is expected to continue.
It should be noted that Dr. Naidoo took the position that Mr. Wheeler did not deteriorate as a result of his cannabis use because he has always been quickly readmitted to the hospital, in order to prevent that from happening and to protect the public. While it is possible that there may be some merit in this argument, it could equally be the case that Mr. Wheeler would not have deteriorated to any significant degree. We simply do not have that evidence either way.
In arriving at its determination this panel closely considered the guidance provided by the ONCA in both the 2024 and 2025 reasons, including at paragraph 16 of Madame Justice Fairburn’s 2024 Reasons for Decision, reproduced earlier in these Reasons for Disposition. After carefully considering the totality of the evidence, we are unable to connect Mr. Wheeler’s predilection for cannabis to a foreseeable and substantial risk of serious physical or psychological harm that is beyond trivial or annoying.
In arriving at its finding this panel also considered a 2022 decision of the ONCA in Re Davies, 2022 ONCA 716 wherein Madame Justice Pepall concludes at paragraph 23:
[23] The evidence linking Ms. Davies cannabis use to an increased risk in public safety was speculative and the Board’s decision was not justified based on the evidence before it and the parties’ submissions: Vavilov, at para. 106. The Board was statutorily required to consider the least onerous and least restrictive disposition in the specific circumstances of Ms. Davies: Criminal Code, s. 672.54; Mazzei v. British Columbia (Director of Adult Forensic Psychiatric Services), 2006 SCC 7, [2006] 1 S.C.R. 326, at
This panel of the Board adopts the same reasoning regarding Mr. Wheeler. This is because the evidence linking an increased risk to public safety to his predilection for cannabis use is speculative.
The panel was not swayed by this sequencing as Dr. Naidoo’s testimony vis-à-vis Mr. Wheeler falling away from treatment. This is because there is no evidence to substantiate that Mr. Wheeler is likely to fall away from psychotropic treatment. More specifically, no evidence of medication non-compliance that follow the 2016 index offences and since coming under Dr. Naidoo’s care in 2017/2018. Given the foregoing, the concern that Mr. Wheeler’s cannabis predilection will precipitate a mental decompensation rising to the threshold of substantial risk of serious physical or psychological harm that is beyond trivial or annoying is theoretical at best. The index offences occurred nine years ago. Since then, there is no indicia of any significant psychotic symptoms, let alone violence, associated with Mr. Wheeler’s use of cannabis. This panel is therefore unable, given the totality of the evidence before us, to draw the required connection between Mr. Wheeler’s future use of cannabis and the re-offence scenarios envisioned by Dr. Naidoo.
As was noted by the ONCA in the 2025 Reasons: “There is no question that the appellant’s chronic addiction to cannabis is a very difficult issue. There is also no question that his treatment team has his best interests in mind.” This panel was required to consider all of the evidence in the legal context, and ultimately we were unable to make a positive finding of significant threat. Mr. Wheeler is therefore entitled to an Absolute Discharge.
Conclusion
For the reasons set out, the Board unanimously determines that Mr. Wheeler is entitled to be absolutely discharged.
In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Naidoo and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Wheeler’s mental condition, his reintegration into society and other needs.
DATED this 24th day of November 2025, at the City of Toronto, in the Toronto Region.
Mr. P. Capelle
Legal Member
Office of the Registrar
Ontario Review Board