Canadian HR Reporter

CANADIAN HR REPORTER JUNE 2018 NEWS 11 from chronic pain, which affects one in five adults, and one in three older adults. And lower back pain is the number one cause of work disability, followed by neck pain, said Furlan. "People started to think: 'Well, we have these powerful drugs and we know they work, why don't we give them for chronic pain?' and that's when the disaster start- ed… the problem is people have chronic pain, so they will (have) chronic pain forever. So if you start someone with chronic pain on an opioid prescription, you are giving this for the rest of their life, and then the body develops a tolerance, and to get the same effect, you need to increase the dose; and the higher the dose, the more effect on the brain and the body. And we know nine to 10 per cent of people who are exposed to drugs every day will develop an addiction," she said. "The crisis we have is well- intentioned doctors wanting to help those patients to overcome their disability chose the easy route and, of course, the pharma industry was fuelling this by tell- ing doctors the addiction was less than one per cent." e medical system is primarily geared to pharmacological solu- tions, said White. "We've created a medical system that tends to rely a lot on pharmacological activity, and then we have drug companies that promise the world… there is good research that opioid use can be useful for some people in early stages of pain, like most surgical pain, that type of thing, but there's also issues of opioids substance abuse and impact on work outcomes." e odds of an employee's re- turn to full employment drop to 50-50 after six months of absence, according to 2006 guidelines from the American College of Occupa- tional and Environmental Medi- cine: "Even less encouraging is the finding that the odds of a worker ever returning to work drop 50 per cent by just the 12th week. e current practice of focusing disability management effort on those who are already out of work rarely succeeds." Alternatives exist In all of the discussions around opioid use and working popula- tions, it's important to remember the alternatives, said Carnide. "(Pain) has to be managed properly," she said. "A lot of workers' comp organizations are introducing policies to reduce opioids — which I certainly un- derstand the impetus behind — but there needs to be consider- ation for what else can workers be offered to ensure their pain is managed properly." is means making sure there's appropriate access to treatments such as physiotherapy and chiro- practic, said Carnide. "Some workers find that there are barriers to accessing those alternative measures or there's delays in accessing them, and really when we think about it… insurance tends to pay most of your prescription medicine, but you tend to have quite a limit on visits to a physio, chiro, to a massage therapist, and so often people then say, 'Well, I have no choice, I have to choose some sort of medication.'" There's good research that cognitive behavioural therapy or physiological intervention can be as effective or more effective for certain people, said White, "and improving coping skills are things that can be learned." "The biggest culprit is this over-reliance on pharmaceutical solutions and, in that way, there are opportunities for companies and HR to ensure that you have a good employee assistance pro- gram, and that those services are utilized," he said. Medical marijuana also holds some potential, said Busse. "ere is interest right now in terms of further exploring the potential role of medicinal can- nabis for treatment of chronic pain, and there's at least some limited evidence to suggest co- prescription of medicinal can- nabis may allow some patients to reduce the amount of opioids they're taking." Anti-inflammatories such as acetaminophen are also possible alternatives, along with spinal manipulative therapy, and some physical therapy modalities, he said. Followup by physicians is also important, along with pre- scribing for shorter periods of time to better track patients. Mindful prescribing has also become more popular, with great- er alignment to guidelines, along with more information provided by pharmacies, said June Dues- berry-Porter, director and chief nursing officer at the WSIB. "ere's an increased aware- ness all around that way, so what we have also seen is an enhanced clinical rationale for the prescrip- tion of opioids with workers." ere's also been a campaign to stimulate conversations between physicians and their patients around what is appropriate care, and judicious use of health care, said ompson. "It limits risk by cutting down on unnecessary diagnostics and unnecessary treatments, and fo- cusing the care." ere's growing appreciation for thinking about the non-phar- macologic modalities for pain management, and the psychologi- cal approach for that pain, he said. "Some of the best pain manage- ment practitioners say that basi- cally the old system — where you try and treat the pain medically first and then when that fails, start thinking about the psychological aspects of pain — that traditional way of thinking needs to be re- versed, where the two need to be combined to adequately address the pain early in the course to op- timize outcomes." To order your subscription call 1.800.387.5164 or 416.609.3800 www.payroll-reporter.com/subscribe Canadian Payroll Reporter is designed to keep you up to date on legislation, regulations, court decisions, technology advances and other developments that affect payroll departments. With the help of Canadian Payroll Reporter you will be able to prioritize your needs and invest in options that optimize your resources. Discover the latest policies and initiatives of the CRA, and how to apply them to your workplace. Receive timely information on pension reform, tax changes, parental leave and other requirements that affect the payroll function. PROVEN METHODOLOGY, PROFOUND IMPACT AND SUSTAINABLE RESULTS Access a sample issue now at: bitly.com/CPR-FreePreview-16 Subscribe today for only $99 * Order No. 20186-18-64768 Save $86 Payroll Reporter Can R Can R adian adian a www.payroll-reporter.com September 2016 see BRITISH COLUMBIA page 7 PM #40065782 Legislative Roundup Changes in payroll laws and regulations from across Canada News in Brief pg. 4 Feds still working to fi x Phoenix payroll problems|B.C. Tax Commission to issue report in October|Little change in average weekly earnings in May Ask an expert pg. 5 Reporting fake SINs|Successor employers and vacation entitlement |Maintaining benefi ts while on leave Alberta Reminder: Minimum wage rates going up The general minimum wage rate in Alberta will rise from $11.20 an hour to $12.20 on Oct. 1. The rate will now apply to liquor servers since the government is eliminating a separate minimum wage rate for them on Oct. 1. Other minimum wage rates are also going up at the beginning of October. The rate for certain salespersons specified in provincial regulations will rise from $446.00 per week to $486.00. The rate for domestic employees who live in their employer's residence will in- crease from $2,127 per month to $2,316. Labour Minister Christina Gray says the government will keep an see CONSIDER on page 6 Credit: Adwo/Shutterstock New folio pg. 3 The CRA has retired its Employee Fringe Benefi ts Employer Interpretation Bulletin and replaced it with a new Income Tax Folio chapter. Advocacy leads to changes Canadian Payroll Association works with government to ensure payroll's voice is heard BY SHEILA BRAWN CODES NOW replace footnotes on the T4. There are now higher thresholds for Can- ada Revenue Agency (CRA) and Revenu Québec accelerated remitters. There are now graduated penalties for late remittanc- es. The timeframe for issuing electronic ROEs now better aligns with pay cycles. These are just some of the changes the Canadian Payroll Association (CPA) has successfully advocated for governments to make in recent years. From source deduc- tions to year-end reporting to employment standards and workers' compensation, CPA president and CEO Patrick Culhane says the association regularly works with government officials and civil servants to make payroll-related laws more efficient and effective for employers, government, employees and the general public. "Advocacy is important to us," says Culhane. "Our core purpose is payroll compliance through education and see GRADUATED page 2 Payroll technology changes don't have to cause headaches Research, well-defi ned plan and stakeholder inclusion help transition BY KIM GROOME BECAUSE PAYROLL plays such a critical role, it can be easy to jus- tify keeping your existing solution even when it means managing work-arounds, manual processes and maintaining external spread- sheets. In spite of this, to provide the best possible experience for em- ployees and to make a more strategic impact in your organization, The Canada Revenue Agency in Ottawa has worked with the Canadian Payroll Association through the years in making changes to payroll-related laws. Start your subscription and receive: • 12 issues of Canadian Payroll Reporter • Full access to www.payroll-reporter.com (including a searchable archive of articles) • Email alerts to keep subscribers up-to-date on breaking news and notifications of new issues TAKE ADVANTAGE OF OUR SPECIAL INTRODUCTORY OFFER *Available to first-time subscribers only OPIOIDS < pg. 7 Different therapies offer promising alternatives

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