Blurred Lines of Intoxication and Insanity: An Examination of the Treatment at Law of Accused Persons Found to Have Committed Criminal Acts While in States of Substance-associated Psychosis, Where Int

Abstract

R v Bouchard-Lebrun is a landmark case. In it, the Supreme Court of Canada brings an end to decades-old debate on the question of whether an accused person is exempt from criminal liability for acts committed in a state of substance-induced psychosis. The Court ruled that individuals in these circumstances do not qualify for the defence of not-criminallyresponsible-by-reason-of-mental-disorder if the psychosis resulted exclusively from voluntary substance use, but left unanswered the difficult question of whether accused persons with co-occurring and contributing substance use and mental disorder (or some other form of neurobiological vulnerability) are subject to criminal liability to the same extent. Included in this article is an overview of the psychiatric literature on substance associated psychosis and an examination of the law governing the attribution of criminal responsibility in such cases, with particular consideration given to the defences of NCRMD and intoxication. What emerges is the view that, notwithstanding the clarification offered by the Court in R v Bouchard-Lebrun, considerable uncertainty remains in the law itself, and in relation to the quality of the medical evidence on which assessments of criminal liability must now be made. It appears that this is especially so in cases of co-occurring and co-contributing substance use and mental disorder, where the evidentiary lines between intoxication and insanity are blurred and the moral blameworthiness of an accused incapable of clear definition.