Reza Hashemi Paraiso, 2025 CanLII 47483

Ontario Review Board

Re: Reza Hashemi Paraiso

ORB File No: 7740

Hearing held on: Tuesday, April 22, 2025

Place of hearing: Ontario Shores Centre for Mental Health Sciences 700 Gordon Street, Whitby

Pursuant to: Section 672.81(1) of the Criminal Code

Before: Alternate Chairperson: Ms. L. Silver Members: Dr. R. Wood Hill Dr. G. Stones Mr. D. D’Intino Mr. J. Cyr

Parties Appearing: Accused: Reza Hashemi Paraiso Counsel: Ms. J. Boissonneault The person in charge of hospital: Representative: Ms. A. Marshall Attorney General of Ontario: Counsel: Mr. T. Hewitt

REASONS FOR DISPOSITION (Dated May 22, 2025)

Introduction

1. Mr. Hashemi-Paraiso was found not criminally responsible on June 8, 2020, for the Criminal Code of Canada offences of sexual assault x 2, and failure to comply with condition of judicial release.

2. He is currently subject to a Detention Order under a Disposition dated February 7, 2024, which provides various terms and conditions, including the opportunity to live in the community in accommodation approved by the person in charge or at a residential treatment facility in Ontario approved by the person in charge.

3. On April 22, 2025, the Board convened an in-person hearing at Ontario Shores to conduct an annual review of his current Disposition to determine whether it was both necessary and appropriate and also the least onerous and least restrictive means to protect the public in the circumstances.

4. The Panel unanimously agreed with the joint submission presented by the parties for a continuation of the current Disposition order with the removal of conditions 2(e), (f), (g) and (h). However, the Panel was split 3-2 on whether to remove the prohibition on the consumption of cannabis from Mr. Hashemi-Paraiso’s conditions.

5. The removal of the prohibition on the consumption of cannabis was requested by counsel Ms. Boissonneault but was opposed by the Hospital and counsel for the Attorney General.

Current Psychiatric Diagnoses:

6. Schizophrenia and Cannabis Disorder – Active, moderate severity.

Index Offences:

7. The details of the index offences are extracted from the previous Reasons for Disposition, which are as follows:

“ On May 9, 2019, Mr. Hashemi-Paraiso was on a TTC subway platform when he touched the buttock of the victim with his hand. Police obtained surveillance video that captured the sexual assault.

On August 5, 2019, Mr. Hashemi-Paraiso followed a 14-year-old girl as she walked from a TTC bus into a subway station. As she followed her mother from the bus, Mr. Hashemi-Paraiso squeezed her buttocks with his fingers. Both incidents were reported to the police.

On November 6, 2019, Mr. Hashemi-Paraiso was arrested for sexual assault and was found to be in possession of a knife. At the time he was subject to a recognizance with a condition prohibiting him from being in possession of a weapon.”

Without Prejudice Position of the Parties:

8. At the commencement of the hearing, Ms. Marshall presented the Hospital’s position, which was a continuation of the Detention Order with the removal of terms 2 (e), (f), (g) and (h).

9. Mr. Hewitt, for the Attorney General, agreed with this position.

10. Counsel for the accused, Ms. Boissonneault, also agreed with the continuation of the Detention Order Disposition and the deletion of the aforementioned terms and asked for the Board to remove the prohibition on the consumption of cannabis from the Detention Order. She proposed that an exception be carved out of the current term to read, “except for cannabis, purchased from a licensed dispensary”.

11. The Hospital and the Attorney General opposed this exception.

Evidence at the Hearing:

12. The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. L. Wong. Counsel Ms. Boissonneault also provided a prior ORB decision involving a cannabis prohibition and the Davies decision of the Ontario Court of Appeal.

13. Dr. Wong did not have any material updates to add to the Hospital Report, and much of his evidence focused on Mr. Hashemi-Paraiso’s cannabis use.

14. Dr. Wong testified that Mr. Hashemi-Paraiso recently relapsed into cannabis use and his passes were held as a result. He testified that despite “rigorous efforts” by the Hospital, there seems to be little to no internal or external motivation by Mr. Hashemi-Paraiso to change his substance use patterns. This has led to an impasse vis-à-vis his discharge because, as Dr. Wong testified, while community housing placements will tolerate some cannabis use, they will not tolerate high frequency use.

15. Dr. Wong testified that Mr. Hashemi-Paraiso uses cannabis “any chance he can” and the only time he doesn’t use is when his passes are held. If the prohibition on cannabis were removed, Dr. Wong testified that in his opinion, Mr. Hashemi-Paraiso’s cannabis use would increase.

16. When Mr. Hashemi-Paraiso has used cannabis in the past, this has led to breakthrough symptoms of psychosis and increased paranoia, disorganization and some irritability, even when he is medication compliant. When he is not medication compliant, these concerns are elevated.

17. Mr. Hashemi-Paraiso tested positive for every Urine Drug Screen (UDS) between September and December 2024, for example. The treatment team has tried a “very out of the box approach” with respect to these positive tests, wherein his passes would only be held for 2-3 days instead of a 1–2-week period.

18. Dr. Wong testified that the “majority of the time” when breakthrough symptoms of psychosis were seen, there was a “clear link” to cannabis use – he would leave the unit in a relatively stable mental state and return noticeably more psychotic. Dr. Wong qualified that these breakthrough symptoms were not severe.

19. When cannabis use is detected or suspected, Dr. Wong stated that Mr. Hashemi-Paraiso was not being particularly forthcoming in terms of disclosing where he obtained the substance.

20. When asked by Hospital counsel whether Dr. Wong believed that Mr. Hashemi-Paraiso was acquiring cannabis from a legal or illegal source, Dr. Wong testified that both sources are “pretty likely”. He later added that one of the risks of consuming illegal cannabis is that it could be contaminated with other substances, and that he believed this risk was quite high.

21. Dr. Wong testified that Mr. Hashemi-Paraiso is on a waitlist for Ballantyne House, which is a supportive housing placement with 24-hour supervision, but that staff there have been clear that they could not accept Mr. Hashemi-Paraiso if he is using cannabis daily. Other housing options are being examined by the treatment team, but substance abuse remains the greatest barrier to Mr. Hashemi-Paraiso’s discharge into the community.

22. In response to questions from counsel for the Attorney General, Dr. Wong testified that the antipsychotic medication is a protective factor for Mr. Hashemi-Paraiso vis-à-vis cannabis use and mental status deterioration. However, Dr. Wong further elaborated that breakthrough psychotic symptoms have emerged even with medication and the absence of cannabis. When cannabis use has been detected, these breakthrough symptoms have become even more of a concern.

23. Dr. Wong further testified that despite these residual and breakthrough psychotic symptoms, since his transfer to Ontario Shores, Mr. Hashemi-Paraiso has not evidenced any severe aggressive behaviors. He opined however, that psychosis is on its own the most significant risk factor that contributes to violent behaviours and that cannabis use increases that risk because it exacerbates the psychosis.

24. In response to questions from Ms. Boissonneault, Dr. Wong agreed that since coming to Ontario Shores, Mr. Hashemi-Paraiso has been compliant with his injectable antipsychotic medication and that his cannabis use has not caused him to be non-compliant with his antipsychotic medications.

25. Dr. Wong also agreed with Ms. Boissonneault that another community placement at Hallsey Lodge could be considered, and that this placement is more tolerant of substance use. He further agreed that it is not uncommon for the Forensic Outpatient Service to manage patients in the community who are using substances.

26. When asked to describe Mr. Hashemi-Paraiso’s stage of change with respect to his use of cannabis, Dr. Wong testified that if there was a stage or degree below “pre-contemplative”, that would be it.

27. In response to Panel questions, Dr. Wong testified that the Hospital has tried to address Mr. Hashemi-Paraiso’s cannabis use from a variety of different angles and even from a harm reduction model without success. Mr. Paraiso-Hashemi doesn’t appear to be motivated to cease or reduce his cannabis use.

28. Dr. Wong also opined that the protective factor offered by the antipsychotic medication is limited, and with increasing cannabis use, increased risk of breakthrough psychosis.

29. When asked by the Panel if he agreed there would be some value to removing the cannabis prohibition and seeing how Mr. Hashemi-Paraiso reacted, Dr. Wong disagreed. He reiterated that cannabis use alone increases the risk of psychosis and violence and that increased cannabis consumption, therefore, increases those risks. There is a direct relationship, according to Dr. Wong, between cannabis use and the degree of psychosis Mr. Hashemi-Paraiso experiences.

30. The Panel directed Dr. Wong to page 20 of the Hospital Report, where an incident took place in the Hospital on June 28, 2023, whereby Mr. Hashemi-Paraiso was placed in the “Quiet Room” after acting in a sexually inappropriate manner toward a female co-patient in the context of increased residual psychosis. Mr. Hashemi-Paraiso spoke in an illogical and incoherent manner and reported that a female voice commanded him to engage in “sexual things in [his] bed”. Dr. Wong agreed that while UDS was negative for cannabis, Mr. Hashemi-Paraiso self-reported consuming cannabis from a used cigarette from the unit balcony around this time.

31. Dr. Wong agreed with the Panel’s suggestion that the delusional beliefs experienced by Mr. Hashemi-Paraiso while at his mental status baseline (as described in paragraph 25 of the Hospital Report) are “core delusional beliefs” and appear to be similar in content to those Mr. Hashemi-Paraiso described to Dr. Komer during his NCR assessment in 2020. In that assessment, Mr. Hashemi-Paraiso espoused those delusional beliefs to Dr. Komer when asked to discuss the circumstances surrounding the index offences.

32. Dr. Wong also further agreed with Panel suggestions that his statements to Dr. Komer suggested that Mr. Hashemi-Paraiso felt compelled to commit the index offences out of his delusional fear of sexual assault, and that there was a concern on the part of the treatment team that cannabis use could increase those delusional beliefs and in turn, his risk to others.

33. Dr. Wong further testified that there are some “pretty big deficits” with respect to Mr. Hashemi-Paraiso’s insight into how his cannabis use is affecting his mental status. Furthermore, Dr. Wong testified that he could say with very high levels of confidence that almost all of the positive UDS screens involved cannabis and that there may have been only one or two instances where the positive result was caused by a substance other than cannabis.

34. In submissions, all parties maintained their initial positions. The Hospital reiterated that Dr. Wong’s evidence established that there is a very clear link between Mr. Hashemi-Paraiso’s cannabis use and negative changes to his mental status. In addition to negatively impacting his access to passes and holding him back from discharge into the community, Mr. Hashemi-Paraiso’s cannabis use increases his risk to the public by exacerbating residual and breakthrough psychotic symptoms.

35. Hospital Counsel noted that the legal definition of “safety of the public” is not limited in the jurisprudence to physical violence, but also includes verbal aggression, intimidation and other similar behaviours, and that when Mr. Hashemi-Paraiso used cannabis in 2023, it resulted in sexually aggressive or threatening comments to co-patients.

36. Furthermore, Hospital Counsel pointed to similarities between the delusional beliefs that played a part in the commission of the index offences and those which he still experiences. She urged the Board to distinguish the Ontario Court of Appeal decision in Davies from the present case because, unlike in Davies, in the present case, there is evidence that links cannabis use to the exacerbation or genesis of breakthrough psychotic symptoms, which in 2023 resulted in an incident of sexual aggression.

37. In relation to the Kelly decision of this Board, Hospital counsel also distinguishes the facts and further notes that ORB decisions of one Panel are not binding on another Panel.

38. Counsel for the Attorney General adopted the Hospital’s submissions.

39. In her closing submissions, Ms. Boissoneault argued that the facts of the present case bear similarities to those in Davies and argued that the Panel should apply the ratio decidendi established in Davies

40. She further argued that there was no evidence of cannabis leading to any violent, aggressive or criminal behaviour by Mr. Hashemi-Paraiso and that, therefore, his behaviour while using cannabis does not rise to the level required by the ONCA in Davies.

41. Ms. Boissonneault also argued that this Panel should follow the Board’s decision in Kell as the facts and legal issues in that case are similar to those in the present matter.

42. She concluded by arguing that it is not Mr. Hashemi-Paraiso’s cannabis use that is preventing his reintegration into the community, but rather the cannabis prohibition itself. She argues that this prohibition needs to be removed and a harm-reduction approach should be taken to manage Mr. Hashemi’s cannabis use concerns.

Analysis and Conclusions – Current Detention Order Disposition

43. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Panel accepts the joint submission position: Mr. Hashemi-Paraiso remains a significant threat to the safety of the public and a continuation of the existing Detention Order Disposition with the aforementioned changes to its terms and conditions (with the exception of the removal of the cannabis prohibition) is necessary and appropriate and the least onerous and least restrictive option in all of the circumstances.

44. Mr. Hashemi-Paraiso suffers from a major psychotic disorder – Schizophrenia – as well as a Cannabis Use Disorder. While the former is largely controlled by medication in the Hospital setting, the latter remains a significant concern which the Hospital has been unsuccessful in treating.

45. Even without cannabis use and with antipsychotic medication, Mr. Hashemi-Paraiso still suffers from breakthrough psychotic symptoms and delusional beliefs. When under the influence of cannabis, his breakthrough psychotic symptoms worsen and it appears that as recently as June of 2023, a resurgence of his delusional beliefs had coincided with some cannabis use, which led directly to an incident of sexually inappropriate behaviour and some threatening comments toward a co-patient.

46. Comments made by Mr. Hashemi-Paraiso at the time of that incident suggested a connection between his behaviour, his consumption of cannabis and his breakthrough psychotic symptoms.

47. In the past, when unwell, Mr. Hashemi-Paraiso has engaged in physical and verbal violence, sexually disinhibited behaviour and sexual violence in the case of the index offences. He has a history of medication non-compliance and chronic substance use (especially cannabis), as well as repeated hospitalizations.

48. In the Hospital, Mr. Hashemi-Paraiso has been compliant with his injectable medication. He has not been compliant with the prohibition on his consumption of cannabis, and the Hospital has seemingly exhausted all options in trying to mitigate or reduce his cannabis consumption.

49. As a result of his lack of insight into the connection between his cannabis use and his breakthrough psychotic symptoms, as well as his total inability to even moderate his cannabis use and his lack of motivation to meaningfully engage in substance abuse programming, Mr. Hashemi-Paraiso remains in Hospital. As set out in the Hospital Report at page 26:

As noted above, Mr. Hashemi-Paraiso performed poorly to addictions treatment, both to traditional groups held by the hospital, and the Contingency Management Program piloted between September-December 2024. He was also resistant and unmotivated to attend residential treatment programming stating, “even if you send me to residential treatment program, I’ll continue to smoke weed”.

Mr. Hashemi-Paraiso’s engagement in CBT for Psychosis and Trauma Informed CBT was quite variable; the former ended due to poor engagement, and the latter was initiated in the second half of the reporting year at his request.

50. The Hospital Report also outlines at page 26, several incidents where Mr. Hashemi-Paraiso either admitted to purchasing or submitted a contaminated urine sample or submitted a cold and clear sample of what was thought to be water – in an effort to evade detection of his cannabis usage.

51. In last year’s Hospital report (found at page 25 of the current Hospital Report), it was reported that, at his baseline, he:

…remained variably preoccupied with longstanding fixed suspicions/paranoia about being “molested” or “telepathically raped…in a secret type of style” by co-patients, officers of the Court, or hospital staff. With concomitant cannabis use, breakthrough symptoms were frequently observed, including increased response to internal stimuli, increased paranoia (he called police services on 2 occasions reported, to the effect, that “pedophiles” were “going to murder and rape me”), bizarre behaviours and statements (i.e., talking about “horses and knights” in an incoherent manner”, walking around with his shirt off due to “overheating”, etc.), inappropriately laughing, and selective mutism. These breakthrough symptoms would typically spontaneously resolve after 24-72 hours when his passes were held [emphasis added].

52. This baseline remains the case even with Mr. Hashemi-Paraiso being medication adherent.

53. The Panel unanimously finds that, absent a Detention Order and the strict oversight of the Hospital, it is likely that Mr. Hashemi-Paraiso would increase his cannabis use, disengage from treatment and become medication non-adherent. This would lead to an exacerbation of his currently present psychotic symptoms, which include (but are not limited to) the same delusional beliefs that led to his commission of the index offences.

Analysis and Conclusions - A Change to the Detention Order to Allow for Cannabis Consumption is Not Appropriate

Majority Decision (Silver and Cyr dissenting)

54. For the reasons that follow, the majority of the Panel agrees with the Hospital that a clear link exists between Mr. Hashemi-Paraiso’s cannabis consumption, his psychosis and delusional beliefs, and by extension his level of risk to the safety of the public.

55. The Panel further finds that the harm-reduction approach instead of the current prohibition as suggested by Ms. Boissonneault is infeasible, given Mr. Hashemi-Paraiso’s lack of insight into his substance use and the risk to his mental status, his total inability to abstain or even moderate his use of cannabis, and the risk to the safety of the public posed by any cannabis use by this person.

56. Beginning with the Hospital Report, the Majority highlights the following relevant passages:

a) As mentioned earlier in this decision, during his NCR assessment conducted by Dr. W. Komer in 2020, Mr. Hashemi-Paraiso provided the following account of the index offences (at pgs 3-4 of the Hospital Report):

While at Waypoint, Mr. Hashemi-Paraiso discussed circumstances surrounding his alleged offences. He said that he committed the sexual offenses, "because Newmarket hospital needs sex" and "they hurt me to get it." When I asked Mr. Hashemi-Paraiso how his actions related to this, he replied, "What I did was for me not to get hurt." He said that he felt he had no choice, "because I couldn't breathe." Mr. Hashemi-Paraiso expressed his view that he should not have been charged, "because the hospital in Newmarket should have been charged." He said that anyone else in his situation would have acted the same way he did. When further questioned, Mr. Hashemi-Paraiso stated, "I think most of it is the hospital in Newmarket. They are addicted to rough sex." He further stated, "The hospital in Newmarket grabs the wrong people and makes them patients for their sexual pleasure." When I asked Mr. Hashemi-Paraiso how this related to his charges, he replied, "I didn't do any sexual assaults." He further said that the charges were false. Mr. Hashemi-Paraiso then said that if he did them, it was because of the hospital in Newmarket. I asked him how this was related to his actions and he replied, "They hurt me for sex" and "I didn't do these assaults." Mr. Hashemi-Paraiso told me that he did not do anything wrong at the time and he should not have been charged. He reported that he did not consume any alcohol or drugs at the time. When asked if he was hearing voices, Mr. Hashemi-Paraiso replied, "No voices." When even further questioned, he stated, "I didn't do them" and "I didn't do it." When I told Mr. Hashemi-Paraiso that he informed me previously that he committed these acts, with regards to his previous statements to me, he stated, "I was lying." When I asked him why he lied to me, he replied, "because that is how I got out of court." Mr. Hashemi-Paraiso said that he did nothing wrong, should not have been charged and had no reason to do them. When further questioned, he stated, “To me, I didn’t do them”. He said that he was right behind the person who did it at the Finch subway station. Mr. Hashemi-Paraiso stated, “I thought it was me because I got arrested” and “The person who I saw in front of me said something like she wanted it”. He told me that he is accused of a crime he did not do and described the person who did it as being taller and more square-faced than him. Mr. Hashemi-Paraiso then made reference to an incident in Richmond Hill involving a woman, Amesha and said that Amesha’s father touched her butt. Regarding his charges, he stated, “No memory myself of doing any assault”. Mr. Hashemi-Paraiso then stated, “I had to touch ass” so that he would not get raped and assaulted by the Newmarket hospital. He told me that he did not do anything wrong and should not have been charged. Mr. Hashemi-Paraiso stated, “It wasn’t my wrong. It was the hospital’s wrong. Obviously the pedo was raping me and would take the Newmarket hospital for sex.” He subsequently told me that “I was controlled to do it”, “Someone made me do it”, “it was the judge or someone like that”, “something forced me to do it” and “someone couldn’t keep their hands off me and made me do it”. Regarding the judge, Mr. Hashemi-Paraiso stated, “He made me touch the ass”. When most recently questioned about these charges, he stated, "I have nothing to do with them" and "No, I didn't do them".

With regards to having a knife in his possession, Mr. Hashemi-Paraiso said that it was his brother’s knife. I asked him if there was a condition prohibiting him from possessing a knife and he told me that the condition was there “to rape me in the ass for sex”, “I needed to have protection from rapists” and “I needed it for my safety… from the pedophile, Hassan”. Mr. Hashemi-Paraiso then said that he had the knife because he wanted to see if it was his brother’s, “by looking at it, studying it”. When further questioned, he said that he had it because he did not know why his father and his friend had the knife which was his brothers. I asked Mr. Hashemi-Paraiso how these were related and he replied, "It wasn't me" and "I don't have the knife". I asked him who had the knife and he replied, "Well I had one knife, but I didn't use it on anyone". When I further questioned Mr. Hashemi-Paraiso as to why he had the knife in his possession, he repeatedly said that he thought it was his brother's knife. When asked why he would have his brother's knife, he said that he did not want his father and "whatever" to hurt his brother and he did not know where his brother was. When I asked Mr. Hashemi-Paraiso where he thought his brother may be, he told me that he did not know.

In short, Mr. Hashemi-Paraiso endorsed delusional beliefs and felt that he “had no choice” [but to commit the index offences] as a result of these beliefs.

b) Mr. Hashemi-Paraiso has long-standing issues with substance abuse, as outlined at pg. 6 of the Hospital Report, which has led to repeated admissions to Hospital beginning in 2005. When he was first admitted to Sick Kids, he was reportedly experiencing “paranoid thoughts, ideas of reference, thought broadcasting and possible auditory hallucinations occurring in the context of him quitting his longstanding substance abuse over two years. He initially described the symptoms occurring within the previous three weeks, which coincided with him stopping using the substances, which included LSD, cocaine, ecstasy, ketamine and cannabis, which he used on a daily basis.”

c) When Mr. Hashemi-Paraiso met with Dr. Leslie at the Hospital for Sick Children on January 13, 2006, he reported using cannabis at that time but denied psychotic symptoms.

d) Between April 28, 2006 and June 13, 2012, Mr. Hashemi-Paraiso required multiple visits to various Hospitals for symptoms including delusional beliefs, auditory and visual hallucinations, blackouts, out of body experiences, physical violence, verbal aggression (including uttering threats of death against his father) and severe aggression requiring four point restraints. Both substance abuse and medication non-compliance were factors in these admissions.

e) Between 2015 and 2018, Hospital records show that Mr. Hashemi-Paraiso was compliant with his injectable medications but continued to show signs of thought disorder and perseveration. He was dishevelled and unkempt and had periods of being unhoused.

f) While at the Toronto South Detention Center after the last index offence, Mr. Hashemi-Paraiso reported using cannabis. This appears to refer to the time of the index offences or the most recent index offence. He also reported quitting cannabis in 2019 and using ecstasy. He was receiving Invega Sustenna by injection at this time.

g) Upon his admission to the Forensic Assessment Program under the care of Dr. Komer, he expressed a number of paranoid and delusional ideas, many relate to being raped by multiple people over the years. Thereafter, he was repeatedly described as responding to internal stimuli, at times becoming aggressive and angry, occasionally hitting or kicking his door, or throwing objects in his room. He would often scream loudly and he remained secluded with brief periods out based upon clinical presentation. He was sexually inappropriate with staff and at times was verbally assaultive. He was extremely preoccupied with the belief that he was being raped every night.

h) In March of 2020, Mr. Hashemi-Paraiso’s paranoid ideas and delusional thoughts did not abate. He continued to struggle with sleep and he continued to voice a belief that staff were sexually assaulting him. Staff found it difficult to build therapeutic rapport, due to his thoughts.

i) During a telephone conversation with the unit social worker on July 9, 2020, his mother, Yolanda Paraiso, expressed that her son should remain in hospital. She voiced concerns regarding her son’s medication compliance when living in the community, given historically, he would be compliant for a week or two before stopping - "he says he doesn't need it anymore". She further stated, "When he's in the community he's unwell, he doesn't take his medication unless someone forces him to". Ms. Paraiso was hopeful that her son can be transferred to a hospital in closer proximity to where she lives, in Scarborough, to facilitate more regular contact.

j) Overall, Mr. Hashemi- Paraiso’s response to medication was described as partial at best. While Mr. Hashemi-Paraiso was reportedly calm and settled through the day, he often presented as unsettled in the evening. This was more evident within a few days prior to receiving his scheduled depot medication. He was often disruptive in the evening, responding loudly and aggressively to hallucinations. He reported increased anxiety, hopelessness and he was often noted to be pacing. Although cooperative to taking routine medication, he refused PRN medications when offered. He demonstrated little insight into his illness and did not believe medication was helpful.

k) On February 18, 2022, Mr. Hashemi-Paraiso was transferred from FARU (a secure forensic unit) to FPRU (a general forensic unit), where he has since remained. Overall, he struggled to make progress over the past reporting year, largely owing to treatment-resistant residual psychosis and repeated cannabis relapse. His engagement in programs also suffered. To his credit, he did not seriously physically aggress, elope from hospital, or require seclusion and/or restraint (though required management in the quiet room on one occasion, which will be articulated below under “Notable Incidents”.

l) On June 28, 2023, Mr. Hashemi-Paraiso was placed in the Quiet Room and on increased observations after acting in a sexually inappropriate manner towards a female co-patient in the context of increased residual psychosis (i.e., paranoid, restless, irritable, even hostile at times). The female co-patient reported that he had been intruding into her personal space, attempted to kiss her, and made sexually inappropriate comments to the effect of, “I feel like raping someone, put a shotgun up someone’s butt, I feel like I want to kiss you right now”.

m) When canvassed by staff, Mr. Hashemi-Paraiso, at times, spoke in an illogical and incoherent manner. He reported that a female voice had commanded and threatened him, “telling me to do sexual things in my bed”. He expressed beliefs that a cult was somehow controlling his power and soul. He reported increased anxiety about an upcoming sleep study. Of note, at the material time, his passes had been held due to ongoing cannabis use; however, despite admitting to picking up and smoking a used cannabis cigarette from the unit balcony, his urine toxicology screen was negative. After a few days, his presentation improved, and he was transferred back to his own room.

n) Notwithstanding the two above-noted incidents, from December 2022-July 2023, Mr. Hashemi-Paraiso’s main struggles were frequent and repeated relapses into cannabis, and one incident of relapsing into alcohol.

• On January 9, 2023, he and a male co-patient attended the plaza down the street from the hospital and each consumed a bottle of wine purchased from the LCBO and then attended the Royal Oak restaurant and consumed some beer. The male co-patient became intoxicated to the extent that EMS was called to assist in the matter. Mr. Hashemi-Paraiso tested 0.84 on the breathalyzer but did not obviously present as intoxicated or psychotic.

When canvassed about this incident, Mr. Hashemi-Paraiso was initially not forthcoming, though later indicated that “I decided to get drunk yesterday” after determining that he had been using his relapse-prevention skills “too much”.

• For the remainder of this period, he frequently relapsed into cannabis, often within days of regaining his privileges, thus perpetuating a cycle where his privileges were held more often than not. His consumption had escalated to the degree that between May-June 2023, his urine toxicology screens continued testing positive for several weeks on end despite his passes being held (i.e., patients are required to show a negative urine toxicology screen before regaining their privileges). Although the team wondered about whether he had covertly consumed cannabis on the unit, the likelihood of this was not considered to be very high.

Furthermore, throughout this period, Mr. Hashemi-Paraiso was referred to an ongoing Concurrent Disorders group targeted at patients who have recently relapsed; however, due to being disruptive in group and espousing pro-substance use attitude, he was removed from same. He was subsequently connected with an individual addictions counselor.

Of note, this period of regular cannabis use also coincided with increased residual symptoms wherein Mr. Hashemi-Paraiso was more overtly responding to internal stimuli and espousing delusional beliefs. Since August 2023, Mr. Hashemi-Paraiso has managed to abstain from cannabis use, citing motivation to be discharged from hospital.

o) Mr. Hashemi-Paraiso evidenced poor-to-mild engagement in structured programming, which worsened as the year progressed, likely owing to his increased substance use and worsening residual symptoms:

• Individual Addictions Treatment: He was connected to an individual counselor after being deemed too disruptive to attend group settings. His engagement was described as sporadic.

• Individual CBT: Attendance was sporadic, and his effort was seen as superficial.

• Restoring Spirituality: He attended 4/5 sessions and was described as an active and meaningful participant.

• Discharge 101: He missed 2/5 sessions due to medical problems, but it was noted that during his attendance, he came across as disinterested and unengaged.

• Goal Setting: He attended 4/5 sessions, and although he was initially engaged in the group, towards the end, he was noted to be quite disruptive, espousing pro-substance use goals to the effect of “smoke weed, eat chicken”.

• Dollars and Cents: Although he attended all 6 sessions, it was remarked that he appeared disinterested in the material, would make disruptive comments to the group, and was unable to follow through with any of the budgeting skills reviewed (i.e., saving money consistently) or develop a realistic budget.

• Family Intervention Therapy: Declined, despite his parents and sister encouraging him.

p) Overall, in examining the present risk factors for the HCR-20V3, it is opined that Mr. Hashemi-Paraiso’s future risk for violence falls within the High range in the context of a Conditional Discharge. The primary risk factor for Mr. Hashemi-Paraiso going forward is his high likelihood of relapse to cannabis use. He has completed Concurrent Disorders counselling in the past which appears to have had a limited impact on his ability to abstain and, as such, may benefit from more intensive substance use treatment such as residential programming. Additionally, regular urine screens will be prudent to monitor his use given that he is not always forthcoming about such. Mr. Hashemi-Paraiso is also encouraged to remain engaged in CBTp as this may assist in the development of insight into his experience, which may help to mitigate some of his risks and prepare him to successfully move through the forensic system. Should he develop some insight into his illness, he would likely benefit from Family Intervention Therapy (FIT) to allow for improvements in his relationships with his mother and father, who will be important supports in the future. Finally, given his difficulty responding to psychosocial treatments over the years, a psychological assessment may be beneficial to assess for any relevant cognitive limitations. Valuable recommendations could be gained from such that would allow future psychosocial treatments to be modified to best suit Mr. Hashemi-Paraiso’s specific learning needs.

q) Since February 18, 2022, Mr. Hashemi-Paraiso has been supervised on a general forensic unit (FPRU). Overall, he struggled with progressing in his rehabilitation mostly owing to ongoing cannabis relapse (more below under “Notable Incidents”) with associated breakthrough psychosis. To his credit, however, he has not engaged in any serious verbal or physical aggression over the past reporting year, and did not elope from the hospital.

r) Most of Mr. Hashemi-Paraiso’s struggles over the past year were due to repeated incidents of cannabis relapse with associated breakthrough psychosis:

• Between September 2023-September 2024, he relapsed into cannabis use on a nearly monthly basis, with his use largely mitigated due to his passes being held and/or cancelled. To that end, not infrequently, he would relapse the day he regained his passes.

• In November 2024, he claimed that he was forced/threatened to consume a glass of wine whilst on hospital grounds as some part of “date rape” scheme. Testing, however, did not support these claims. His mental status also appeared unchanged.

• On at least one occasion (February 2024), there were concerns that he either smuggled and/or received contraband whilst his passes were held owing to a new positive urine toxicology result for cannabis with an associated change in his mental status.

• On at least another occasion (July 2024), he admitted to purchasing and/or submitting a contaminated urine sample in an effort to evade detection. On another occasion (September 2024), he provided a cold and clear sample thought to be water; his re-submitted urine sample would later test positive for cannabis.

• At times, Mr. Hashemi-Paraiso would readily admit to seeking out and using cannabis, whilst at other times, he would describe acquiring it via somewhat unusual scenarios (i.e., being forced to consume some sort of contaminated/unknown beverage).

Between September-December 2024, Mr. Hashemi-Paraiso was enrolled into the Contingency Management Program (CMP), a pilot project targeting high-frequency substance users who have evidenced little improvement in traditional addictions treatment. This program focused on incentivizing substance abstinence, and limited passes were held for 24-72 hours so long as their violence risk was deemed manageable. Daily urine toxicology screens were implemented.

Unfortunately, he essentially tested positive nearly every day owing to his frequent cannabis use, and even when this program finished, he continued to test positive for cannabis for over 3- weeks (despite having his passes held), which was reflective of his chronic use and how much remained stored in his adipose tissues.

57. The Majority of the Panel finds that the above-noted excerpts from the Hospital Report, when combined with the viva voce evidence of Dr. Wong, establishes that cannabis consumption causes or exacerbates Mr. Hashemi-Paraiso’s psychotic symptoms, which include delusional beliefs. Those delusional beliefs and cannabis consumption were factors in the commission of the index offence and the incident in June 2023, whereby Mr. Hashemi-Paraiso was sexually aggressive and inappropriate toward a female co-patient.

58. We are thus satisfied that cannabis consumption directly increases the risk to the safety of the public that is posed by Mr. Hashemi-Paraiso, and that cannabis elevates his risk notwithstanding his medication compliance. This conclusion is supported by both documentary and oral evidence and is not speculative in nature.

59. Ms. Boissonneault relies on the Davies¹ case from the Ontario Court of Appeal in advocating for the removal of any conditions in the Disposition prohibiting Mr. Hashemi-Paraiso from consuming cannabis.

60. In Davies², the ONCA cited three errors made by the Board in their decision not to grant an exemption to Ms. Davies, which would allow her to consume cannabis:

1. The Board’s reasons conflated the terms “substances” and “cannabis”, without sufficient evidence demonstrating that Ms. Davies’ cannabis use would pose a significant risk to public safety. In its reasons, the Board discussed the manner in which “substances” more generally increased Ms. Davies risk to public safety. It found that “substances were at play during the index offences and the attack on her then psychiatrist”. The Board had no evidence before it that directly linked cannabis to the commission of the index offence.

2. Second, the Board’s Reasons, the Hospital Report and the evidence before the Board, conflate “a patent risk of psychosis” with a significant threat to public safety. In other words, while cannabis use may create a “patent risk for psychosis” for Ms. Davies, there was insufficient evidence that cannabis use in a controlled hospital environment, with a medicated and compliant patient, such as Ms. Davies, would rise to the level of a significant risk to public safety.

3. Third, while there are numerous incidents throughout the record where Ms. Davies’ consumption of cannabis has not been connected with any acts of violence, the Board’s Reasons do not explain its ultimate conclusion that cannabis use in a controlled and monitored environment would pose a significant risk to public safety.

61. Davies can be distinguished on its facts from the present case.

62. In Davies, cannabis was not a factor in the commission of the index offences. In the present case, the Hospital Report states at page 11 that Mr. Hashemi-Paraiso self-reported the use of cannabis either proximate to or contemporaneously with the index offences. He also stated that he quit using cannabis in 2019 and that he was using ecstasy.

63. Secondly, the Panel in our present case heard evidence that the same delusions which made Mr. Hashemi-Paraiso feel compelled to commit the index offences are made worse when he has been confirmed to use cannabis.

64. Thirdly, unlike the Panel in Davies, this Panel had evidence that while in the Hospital, Hashemi-Paraiso had exhibited sexually inappropriate behaviour that was similar to the index offences, and when confronted about it, he self-reported using cannabis.

65. Fourthly, unlike the Panel in Davies, this Panel received testimony that despite medication compliance, Mr. Hashemi-Paraiso still experiences breakthrough psychosis, still displays bizarre beliefs and delusions, and when combined with cannabis use, those symptoms are exacerbated and have led in 2023 to him engaging in sexually inappropriate behaviour with a co-patient.

66. Lastly, in Davies, the ONCA faulted the Board for “conflat[ing] “a patent risk of psychosis” with a significant threat to public safety. The ONCA found that “there was insufficient evidence that cannabis use in a controlled hospital environment, with a medicated and compliant patient, such as Ms. Davies, would rise to the level of a significant risk to public safety.”

67. The evidence before the Board in respect of Mr. Hashemi-Paraiso is markedly different. Unlike Ms. Davies, Mr. Hashemi-Paraiso can hardly be called “compliant” – the Hospital report is replete with dozens of examples of his habitual non-compliance with Hospital rules surrounding cannabis use and some examples of tampering with urine drug screening. His engagement and follow-through with recommended substance abuse-related programming is also quite poor.

68. Even though Mr. Hashemi-Paraiso is living in a structured environment and has been medication compliant, his cannabis use and resultant breakthrough psychosis led to sexually inappropriate and concerning behaviour toward a co-patient. The Hospital Report at p. 25 makes a direct link between cannabis use and breakthrough psychotic symptoms, which include increased rumination surrounding bizarre delusional beliefs that are substantially similar to those which compelled him to commit the index offences. These delusions are described at page 16 of the Hospital Report as being “treatment resistant”.

69. When interviewed by Dr. Komer in 2020 about the index offences, he denied substance use at the time of commission, but endorsed bizarre beliefs similar to those described by the Hospital Report in more recent entries, and engaged in sexual behaviour similar to that which occurred following cannabis use in 2023.

70. Sexually inappropriate behaviour and comments or threats surely would cause psychological harm within the meaning of Winko, and furthermore, Hospital patients have been considered “members of the public” for the purposes of the Winko test.³

71. Earlier in this decision, we held that Mr. Hashemi-Paraiso does meet the threshold for significant threat to the safety of the public. This finding was based in part on the very same incidents which occurred while the accused was under the influence of cannabis, but mainly on concerns which arise even when he is not.

72. Given the evidence in the Hospital that Mr. Hashemi-Paraiso’s breakthrough psychosis is either caused by or exacerbated by his concomitant cannabis use, and the professional opinion of Dr. Wong that further consumption of cannabis would likely exacerbate his existing psychosis, it follows then that under the influence of cannabis the significant threat posed to the public by Mr. Hashemi-Paraiso would be exacerbated rather than attenuated.

73. Lastly, while the ONCA concluded that “there was insufficient evidence that cannabis use in a controlled hospital environment, with a medicated and compliant patient… would rise to the level of a significant risk to public safety”, it is important to note that the diagnoses and treatment efficacies between Ms. Davies and Mr. Hashemi-Paraiso are markedly different.

74. In Davies, the accused had the following diagnoses:

• Schizophrenia;

• Cannabis Use Disorder;

• Alcohol Use Disorder; and

• Borderline Personality Disorder.

75. It is unclear from the ONCA decision what medications Ms. Davies was prescribed, but the Court described her as “medicated and compliant” and so for our analysis, we assume the Court was satisfied that Ms. Davies was prescribed medication, that she was compliant in taking it, and that it was effective at controlling her psychotic symptoms.

76. The concern for the hospital vis-à-vis cannabis use by the accused was that of causing or exacerbating symptoms of psychosis, either as a consequence of, or a cause of, medication non-compliance. This conclusion flows from the Court’s dictum at paragraph 18:

18The Board also found that, “[a] resort to substances and a corresponding cessation of medication will cause the risk of harm to the public to increase” (emphasis added). The Board’s reasons do not disclose that cannabis, in and of itself or in particular, had the effect of increasing Ms. Davies’ threat to public safety. Even if taken at its highest, in order for Ms. Davies to pose a significant risk to public safety, two events must occur. The first is a resort to substances, and the second is a cessation of medication. The former requirement is insufficiently precise and the latter requirement is unsupported by the evidence of Ms. Davies’ treating psychiatrist, Dr. Sutton, who testified that she has been largely compliant with her medication regime. It is also incongruent with the evidence that the Hospital could continue to monitor Ms. Davies’ medication compliance while detained and consuming cannabis.

77. Mr. Hashemi-Paraiso is in a very different situation in several respects, most importantly in that Dr. Wong specifically testified that Mr. Hashemi-Paraiso’s medication does not seem to completely prevent breakthrough psychosis or eliminate his delusional beliefs. These concerns are made worse by the consumption of cannabis, and as seen in June 2023, despite being medication compliant and consuming cannabis, Mr. Hashemi-Paraiso experienced delusional beliefs, which in whole or in part led to sexually inappropriate behaviour against a co-patient.

78. This alone distinguishes his case from that of Davies, because unlike in her case, Mr. Paraiso-Hashemi’s risk of violence or sexually inappropriate behavior does not hinge on cannabis use and medication non-compliance.

79. Thus, the case at bar is quite different from that of Davies in that, whereas it appears that the evidence before the Board suggested that cannabis use would lead to medication non-compliance when then would lead to a significant threat to the safety of the public, in Mr. Hashemi-Paraiso’s case, the evidence of Dr. Wong is that cannabis consumption would directly increase the significant threat to the safety of the public due to the causal relationship between cannabis ingestion and breakthrough psychotic symptoms, delusional beliefs and his past willingness to act on those beliefs in a sexually assaultive or threatening manner.

80. Ms. Boissonneault also filed the Re: Kelly case in support of her position, which is a prior decision of a differently constituted panel of the ORB.

81. As Ms. Marshall correctly pointed out, the Panel is not bound to follow decisions of other members of the ORB. This principle was set out by the ONCA in R. v. TransCanada Pipelines Ltd⁴, at paragraph 129:

[129] Moreover, there is a well-accepted principle of administrative law that stare decisis does not apply to administrative tribunals. A tribunal is not bound to follow its own decisions on similar issues, although it may consider an earlier decision persuasive and find that it is of assistance in deciding the issue before it. See, e.g., Evans v. Public Service Commission Appeal Board, 1983 CanLII 141 (SCC), [1983] 1 S.C.R. 582; Domtar Inc. v. Quebec (Commission d’appel en matiere de liasions professionelles) (1993), 1993 CanLII 106 (SCC), 105 D.L.R. (4th) 385 (S.C.C.).

82. While the ONCA in TransCanada held that prior decisions of an administrative tribunal can be persuasive and of assistance in deciding issues in another case, the Majority for the reasons that follow, finds that Kelly is distinguishable on its facts and also, that the Panel made logical errors in that case which make its reasoning unsound.

83. Unlike in the present case the Panel in Kelly found that there was no connection between cannabis use and the index offences.⁵

84. Also, unlike the present case the Panel found that the case of Mr. Kelly was similar to that of Ms. Davies and that the Panel had no evidence upon which it could conclude that Mr. Kelly’s use of cannabis enhanced his risk to the safety of the pubic.⁶

85. Lastly, the Panel in Kelly engaged in problematic reasoning that rendered its decision unsound.

86. At paragraph 59, the Panel writes:

The panel is aware that there are specific historical incidents identified in the Hospital Report and highlighted in the doctor’s evidence when Mr. Kelly’s cannabis use resulted in his presenting as “irritable” and “disinhibited”. We note that according to the doctor’s evidence, it took several months for him to return to his best baseline presentation after his most recent confirmed cannabis use in May 2023. However, we are also mindful of the fact that there are also numerous reported incidents where Mr. Kelly’s consumption of cannabis did not result in him suffering any deterioration in his mental state or engaging in violent or threatening behaviour. We acknowledge that following his most recent occasion of cannabis consumption, Mr. Kelly expressed delusional thought content and was noted to be more disinhibited. However, in this panel’s assessment, his behaviour did not rise to the level required to establish an increased risk to public safety. Mr. Kelly did not engage in any incidents of either verbal or physical or sexual aggression over the year in review. Nor did he engage in any criminal conduct [emphasis added].

87. There are two problems with the logic in this paragraph. Firstly, the conclusion of the Panel that Mr. Kelly’s consumption of cannabis did not result in him suffering any deterioration in his mental state or engaging in violent or threatening behaviour is contradicted by its own findings at paragraphs 21-22 of Kelly:

88. Over the year in review, Mr. Kelly’s UDS were negative except for one occasion on May 29, 2023, when his UDS returned positive for cannabis. The positive result lasted for several days. In response, Mr. Kelly’s privileges were put on hold. Since June 1, 2023, all of his UDS have returned negative.

89. Following that single episode of cannabis use at the end of May 2023, Dr. Chuong advised that Mr. Kelly expressed delusional thought content and was more disinhibited. He was soliciting sexual favours from co-patients and he engaged in non-violent harassing behaviour directed at a hospital employee. He also presented as considerably more disinhibited, and was propositioning people for sex. The doctor noted that following his cannabis use, a clear change in his mental state was observed. The doctor testified that he did not return to his previous baseline presentation for several months following his cannabis use [emphasis added].

90. Clearly, the Panel had evidence before it that cannabis use has led directly to a decompensation in Mr. Kelly’s mental state which led to sexually inappropriate behaviour and furthermore, required several months for Mr. Kelly to return to his mental status baseline.

91. Moreover, it is concerning that the Panel concluded that Mr. Kelly’s cannabis consumption did not lead to him engaging in violent or threatening behaviour because this statement is misleading. While it is somewhat factually correct, it ignores the fact that while under the influence of cannabis, Mr. Kelly was engaging in sexually inappropriate behaviour that was described in the Hospital Report as harassing in nature.

92. Sexual harassment may not be physically violent and may not involve the threat of physical violence but it is psychologically harmful to both co-patients and Hospital Staff, both of whom are considered “members of the public” vis-à-vis test in Winko. The Panel in Kelly seemingly ignored this fact when coming to the above noted conclusion.

93. Similarly, the Panel’s reasoning in Kelly that, “there are also numerous reported incidents where Mr. Kelly’s consumption of cannabis did not result in him suffering any deterioration in his mental state or engaging in violent or threatening behaviour”, is equally problematic.

94. The fact that Mr. Kelly sometimes consumed cannabis and did not act in a violent, threatening or sexually inappropriate manner is not the test set out in the Code, or in Winko or in Davies.

95. The test in Winko, applied to Mr. Kelly, is whether he presented a significant threat to the safety of the public.

96. The test in Davies, applied to Kelly, asks whether his behaviour while under the influence of cannabis rose to the level required to establish an increased risk to public safety. Arguably, the Panel’s conclusion that it did not meet this threshold is undermined by its own conclusions at paragraph 22 of the Kelly decision, as well as the problematic foundation of reasoning that its decision rested upon.

97. For those reasons, the Majority of this Panel both distinguishes this case from and declines to follow Kelly.

98. The Panel is tasked with determining the least onerous and least restrictive Disposition in the specific circumstances of Mr. Hashemi-Paraiso.

99. It must also consider whether the evidence presented in this case is such that Mr. Hashemi-Paraiso’s use of cannabis increased the risk he posed to public safety. The Board has, in previous cases, taken a liberal and purposive approach to interpreting who is included in the term “public safety”, which in our view does include Hospital staff and co-patients.⁷

100. The Supreme Court of Canada in Winko was clear that psychological harm is included in the “significant threat to the safety of the public” consideration.⁸ Unlike the cases of Davies and Kelly, this Panel has clear evidence linking Mr. Hashemi-Paraiso’s consumption of cannabis to the exacerbation of the delusional beliefs which compelled him to commit not only the index offences but also the incident in June 2023.

101. In other words, despite his medication compliance, his consumption of cannabis causes and exacerbates his psychotic symptoms, which include his delusional beliefs, and Mr. Hashemi-Paraiso has demonstrated a willingness to act on those delusional beliefs in a sexually inappropriate or violent manner.

102. The evidence before us clearly establishes that cannabis consumption markedly increases the risk Mr. Hashemi-Paraiso poses to public safety.

103. Lastly, in contrast to what Ms. Boissonneault argued in submissions, the Majority finds that it is not the prohibition of cannabis consumption that is preventing Mr. Paraiso-Hashemi’s discharge into the community.

104. Rather, it is his near total lack of engagement in substance abuse programming, his lack of insight into the connection between his cannabis consumption and his unacceptable behaviour, and his total inability to even moderate or restrain his cannabis consumption, which has kept him in the Hospital.

105. The Hospital has made exemplary efforts to try and get through to Mr. Hashemi-Paraiso and assist him in achieving abstinence from cannabis or to at least develop insight into the negative effect it has on his mental status and his behaviour. These efforts have been in vain, however, because, as the Hospital Report states, Mr. Hashemi-Paraiso seems to lack both internal and external motivation to achieve abstinence or at least the ability to moderate his cannabis consumption.

106. For those reasons, the Majority of the Panel agrees with the Hospital and the Attorney General that the prohibition clause in the Detention Order should not be modified or removed to allow Mr. Hashemi-Paraiso to consume cannabis.

Dissenting Reasons of L. Silver and J. Cyr

105. The minority panel has carefully considered the evidence, the submissions of counsel, and the applicable legal principles, particularly the requirement under section 672.54 of the Criminal Code that the Board impose the least onerous and least restrictive disposition necessary in the circumstances.

106. For the reasons that follow, the minority concludes that the prohibition on cannabis use set out in Provision 4(a) of the previous Disposition should be amended to permit the consumption of cannabis obtained from a licensed dispensary.

107. Mr. Hashemi-Paraiso has been diagnosed with Cannabis Use Disorder (Active, Moderate Severity) and has demonstrated chronic, recurrent cannabis use over his many years under the jurisdiction of the ORB.

108. Mr. Hashemi-Paraiso’s rehabilitation has been hindered primarily by repeated cannabis relapse and associated breakthrough psychosis. Mr. Hashemi-Paraiso performed poorly in both traditional group addiction programs and the Contingency Management Program (CMP) conducted from September to December 2024.

109. Mr. Hashemi-Paraiso has consistently resisted abstinence-based approaches, stating, “Even if you send me to a residential treatment program, I’ll continue to smoke weed."

110. Throughout the reporting period, Mr. Hashemi-Paraiso repeatedly lost privileges following cannabis use. Upon regaining those privileges, he relapsed again, creating a persistent cycle that has endured for several years.

111. While enrolled in the CMP, Mr. Hashemi-Paraiso tested positive for cannabis nearly every day, despite the program’s structure of incentivized abstinence, limited passes, and daily urine testing.

112. Mr. Hashemi-Paraiso reports that he enjoys using cannabis, finds it calming, and has no intention of stopping.

113. Dr. Wong confirmed that cannabis use remains the primary barrier to Mr. Hashemi-Paraiso’s discharge to the community. Most group homes would decline to accept him, except for Halsey Lodge, which allows responsible cannabis use.

114. Dr. Wong opined that there is a clear association between Mr. Hashemi-Paraiso’s cannabis use and the exacerbation of his psychotic symptoms, including increased paranoia, irritability, and disorganization, potentially heightening his risk profile over time.

115. Neverthelss, Dr. Wong acknowledged that despite near-daily cannabis use during the CMP in Fall 2024, Mr. Hashemi-Paraiso did not engage in any violent or aggressive behaviour.

116. Furthermore, Dr. Wong testified that since March 2021, there has been no evidence of severe verbal or physical aggression while Mr. Hashemi-Paraiso has remained adherent to his medication regimen.

117. Dr. Wong expressed no concerns about Mr. Hashemi-Paraiso’s compliance with his long-acting injectable medication. Mr. Hashemi-Paraiso has consistently accepted and adhered to his prescribed treatment.

118. Dr. Wong nonetheless maintained that the absence of aggressive incidents is attributable to the hospital’s external risk management strategies, particularly the revocation of passes limiting Mr. Hashemi-Paraiso’s cannabis use.

Analysis

119. The minority was guided by the Court of Appeal’s decision in Davies (Re), 2022 ONCA 716 and the Board’s decisions in Kelly Re (February 2024) and Amero (Re), [2020] O.R.B.D. No. 2618.

120. The Board’s statutory mandate under section 672.54 requires it to impose the least onerous and least restrictive disposition consistent with public safety, the mental condition of the accused, the reintegration of the accused into society, and the accused’s other needs.

121. As in Amero, where no causal link was found between cannabis use and the index offence, the evidence here similarly fails to establish that Mr. Paraiso’s cannabis use precipitated or contributed to the index offence, despite his substance use history during the period leading up to the offence.

122. While Dr. Wong associated increased cannabis use with deterioration of Mr. Hashemi-Paraiso’s mental state, such as increased paranoia, irritability, and disorganization, he acknowledged that there has been no violence or serious aggression since March 2021.

123. The minority acknowledges the incident referenced by the majority, which occurred in June 2023. However, this incident occurred nearly two years ago and has not been repeated. Moreover, as noted in the Hospital Report, Mr. Hashemi-Paraiso’s passes were being held at the time due to concerns about ongoing cannabis use. Although he admitted to finding and smoking a discarded cannabis cigarette from the unit balcony, his urine toxicology screen was negative. This suggests that the residual contents of the cigarette were insufficient to register on the toxicology screen and, therefore, unlikely to have had any significant psychoactive effect or have contributed meaningfully to his psychotic presentation.

124. In the minority’s view, the denial of privileges has been based solely on violations of the cannabis prohibition, not on any demonstrated increase in risk to public safety.

125. The current prohibition on cannabis use has failed to reduce Mr. Hashemi-Paraiso’s cannabis use. Instead, it has perpetuated a cycle of privilege revocation without addressing the underlying issue.

126. Dr. Wong himself acknowledged that revoking privileges to limit substance use is a “blunt tool” that has proven largely ineffective in curbing Mr. Hashmi-Paraiso’s cannabis consumption.

127. Given Mr. Hashemi-Paraiso’s entrenched cannabis use, his clear refusal to abstain, and the absence of violence or serious aggression since March 2021, the minority concludes maintaining the absolute prohibition is not the least onerous or least restrictive option.

128. Mr. Hashemi-Paraiso is currently subject to a detention order and is detained within a structured hospital environment. Permitting cannabis use during community passes would enable the hospital to closely monitor any changes in his mental state and ensure its capacity for timely intervention should his condition deteriorate.

129. Should Mr. Paraiso be discharged to the community within the next year, it is anticipated that he will transition to a highly supervised environment. As previously noted, (see paragraph 9), according to Dr. Wong, Mr. Paraiso will most likely be discharged to Halsey Lodge, a group home that permits responsible cannabis use.

130. He will remain subject to a Detention Order, which provides the hospital and the Board with the necessary authority to manage emerging risks, including by seeking an expedited hearing if needed.

Conclusion

131. The minority finds that the least onerous, least restrictive, necessary, and appropriate disposition is to maintain the current Detention Order subject to an amendment of Provision 4(a), to permit Mr. Paraiso to consume cannabis obtained from a licensed dispensary.

DATED this 22^nd^ day of May 2025, at the City of Toronto, in the Toronto Region.

Mr. D. D’Intino Legal Member

___________________________ Office of the Registrar Ontario Review Board

Footnotes

1. 1Davies (Re), 2022 ONCA 716
2. 2Davies, ibid.
3. 3Jaegar (Re), [2007] O.R.B.D. No. 1960 at para 46; C.H.H.M. (Re), [2005] O.R.B.D. No. 101 at para 68; Patterson (Re), [2016] O.R.B.D. No. 3162 at para 32; Williams (Re), [2010] O.R.B.D. No. 1904 at para 50
4. 42000 CanLII 5713 (ON CA)
5. 5Re: Kelly, supra, at para 28.
6. 6Re: Kelly, supra, at para 58.
7. 7Jaegar (Re), [2007] O.R.B.D. No. 1960 at para 46; C.H.H.M. (Re), [2005] O.R.B.D. No. 101 at para 68; Patterson (Re), [2016] O.R.B.D. No. 3162 at para 32; Williams (Re), [2010] O.R.B.D. No. 1904 at para 50
8. 8Winko, supra, at para 57