Drug ban lifted for Ontario man who stabbed 83-year-old stranger while on drugs

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The 37-year-old now lives in a subsidized one-bedroom apartment in St. Thomas.

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His psychiatrist “stated that the treatment team is seeking to prepare Mr. Pillar for discharge from the forensic system, and is therefore recommending a removal of the ‘abstain’ clause from his disposition,” said the recent ORB decision.

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“To be clear, the treatment team prefers that Mr. Pillar not use substances, so (his psychiatrist) sees the coming reporting year as an important time of testing for him. There have been some indications that Mr. Pillar may wish to use alcohol or cannabis. In (his psychiatrist’s) opinion, decompensation would be quick if he were to use either substance.”

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During a hearing last month at the Southwest Centre for Forensic Mental Health Care “counsel for all parties agreed that Mr. Pillar represented a significant threat to public safety” and that his ban on “the non-medical use of alcohol or other intoxicating substances” should be dropped, said the decision.

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Pillar’s life before the stabbing “was marked by heavy substance use, mental health issues, and criminal behaviour,” said the decision. “He reportedly started using alcohol when he was nine years old.”

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Pillar “started using cannabis at age 11, cocaine at age 14, and crystal methamphetamine at age 25.”

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While he drank alcohol and used other drugs, “crystal methamphetamine was the drug that he used most from age 25 or 26 onward,” said the decision.

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In the years before the stabbing, he was the subject of “multiple Community Treatment Orders, during which Mr. Pillar continued to use drugs and alcohol and was non-compliant with his prescribed medication and appointments,” said the decision. “The history also includes several attempts at mental health diversion for various criminal charges. His reported symptoms, when unwell, included command auditory hallucinations to kill both men and women, but chiefly women. Notably, while in pre-trial detention at the South-West Detention Centre in April of 2017, he struck a correctional officer and explained that he did so in response to voices telling him to hit staff.”

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In August 2018, months after he was admitted to hospital because of the stabbing, “Pillar became violent and attacked a nursing station to which a female staff member had retreated from him after he became angry with her,” said the decision. “He had engaged in significant environmental damage and continued to fixate on the staff member, stating that he wanted to kill her. He also threatened to stab someone in the eye and kill them if he gained weight from his injection of antipsychotic medication. He was placed in seclusion and later tried to grab a female staff member through an opening in the seclusion room door.”

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Pillar “continued to display unpredictable and angry behaviour through his initial reporting period following his NCR finding,” said the decision. “He often glared angrily at staff, was observed responding to internal stimuli, and acknowledged experiencing both auditory and visual hallucinations.”

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In November 2018, Pillar started taking clozapine, an anti-psychotic, said the decision. “His mental state gradually improved and Mr. Pillar reported that his hallucinations gradually ceased after he started receiving clozapine.”

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Pillar relapsed in May 2019, said the decision. “He was glaring into the nursing station with clenched fists, was experiencing restlessness and difficulty settling at night, and was anxious and preoccupied in his thoughts. During this time, he was tapered off one of his antipsychotic medications. However, he eventually tested positive for methamphetamines and later admitted its use during the period of the behavioural changes described.”

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Doctors upped Pillar’s clozapine dose “in October of 2019 after he impulsively attacked and repeatedly punched another patient with a closed fist. The victim sustained multiple blows to the head and bruising and edema to the right eye and cheek.”