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Timothy Stapleton: Fighting the opioid epidemic in the exam room

FMA CEO Timothy J. Stapleton

The United States is in the midst of a public health crisis. Opioid addiction is taking mothers, fathers and children; destroying lives, breaking up families. The problem is particularly insidious in Florida, which has become a destination for rehabilitative services and sober home living. In the first part of 2016, approximately 2,600 people died from opioid overdoses in the state and the epidemic shows no sign of slowing.

Gov. Rick Scott recently declared a public health emergency over this crisis, which frees up nearly $30 million in federal funds to fight this battle for Floridians. State Surgeon General Celeste Philip, M.D., has been directed to keep a standing order of Narcan and Naloxone — drugs used to counteract overdoses — at the ready, and Attorney General Pam Bondi, who was recently appointed to President Donald Trump’s Opioid and Drug Abuse Commission, has secured a deal for the two drugs to be purchased at a discounted rate.

The Florida Medical Association (FMA) represents more than 20,000 physicians in the state and provides them with access to expert advice, support and resources. As an advocate for the highest standards of medical care, we stand alongside our state’s leaders as we work to reverse the destruction being caused by opioid addiction and overdose in our state.

It’s up to all of us to come together as a community to fight this rampant problem at every level: education, prevention, treatment and recovery services. Physicians can effect positive change by staying educated on best practices and effectively communicating with their patients about treatment protocols for pain management. There is an inherent risk in prescribing highly addictive medications, particularly for patients suffering from severe chronic pain. Physicians have a duty to consider the risks versus clinical effectiveness of prescribing opioids and communicate those risks and benefits clearly and honestly to their patients.

The FMA recommends that physicians follow the U.S. Centers for Disease Control and Prevention recommendations for prescribing opioids. This includes starting “low and slow” with dosages and prescribing no more than needed for acute and chronic pain. Physicians also have a responsibility to follow up with their patients, to ascertain effectiveness of treatment and, when necessary, include strategies to mitigate the risk of addiction or overdose.

Florida has established a state prescription drug monitoring program (PDMP) to access and review an individual’s history of controlled substance use before making any decisions on best course of treatment. PDMP data is used by prescribers to avoid dangerous drug combinations that would put a patient at high risk for potential addiction or overdose. This, along with urine drug testing to identify prescribed substances and undisclosed use, prevents pill-seeking patients from “doctor shopping.” The FMA encourages physicians to utilize the database, along with established protocols, protections and research, to ensure that they are able to make appropriate clinical decisions for their patients and prescribe treatments responsibly, safely and effectively.

Physicians have an obligation to educate their patients while developing treatment goals. Treatment does not end when a prescription is written: An open line of communication is necessary to make appropriate clinical decisions and detect signs of opioid dependence.

The FMA remains steadfast in our commitment to the people of Florida who entrust their health to physicians. We will do even more as we continue fighting to protect patients’ health and well-being by arming Florida physicians with the tools necessary to empower their patients. Irresponsible treatment plans and illegal distribution of opioids have no place in the medical field.

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Timothy J. Stapleton is CEO of the Florida Medical Association.  

David Richardson seeks to bring his brand of reform politics to D.C.

Miami Beach House Democrat David Richardson will run for the Congressional District 27 seat being vacated next year by Republican Illeana Ros-Lehtinen.

Richardson has served in the Florida House since 2012, when he became the first openly-gay lawmaker elected in Florida.

He had been considering entering the race after Ros-Lehtinen announced in late April that she would step down when her term ended next year. Richardson told FloridaPolitics’ Scott Powers last month that he would be traveling to Washington D.C. to discuss his candidacy with potential donors and supporters, including leaders of The Victory Fund and the Democratic Congressional Campaign Committee (DCCC).

News of Richardson’s candidacy was first reported on Tuesday by the Miami Herald.

In his time in the House, Richardson has focused intensely on reforming Florida’s prison system, and just in the past year met with more than 120 inmates during more than 30 visits to 23 different corrections facilities, according to the Herald.

Florida’s 27th congressional district was targeted by the DCCC prior to Ros-Lehtinen’s announcement. It’s a district in which Hillary Clinton defeated D0nald Trump by 20 percentage points.

Richardson joins a crowded field of Democratic candidates for the race, which also includes state Senator Jose Javier Rodriguez, Miami Beach commissioner Kristen Rosen Gonzalez, University of Miami academic adviser Michael Hepburn and Mark Anthony Person. 

On the GOP side, former Miami Dade County school board member Raquel Regalado ,Miami-Dade County commissioner Bruno Barreiro  and Dr. Maria Peiro have announced their candidacies for the seat. Peiro lost to Ros-Lehtinen in the GOP primary last August.

Scott Furhman, the South Miami businessman who lost to Ros-Lehtinen last fall, announced on Tuesday that he would not be running for the seat this year, and told the Herald that he will be backing Richardson in the Democratic primary.

New Port Richey Democrat Linda Jack to challenge Amber Mariano in state House Distirct 36

Democrat Linda Jack, a veterinarian from New Port Richey, has filed to run for the Florida House District 36 seat currently held by Republican Amber Mariano. 

Dr.Jack is a Florida native who spent many years traveling, performing and teaching as a professional musician, based in New York, Boston and Nashville. She then switched careers after obtaining a Doctorate in Veterinary Medicine in 2006 from North Carolina State University and subsequently worked in Virginia and North Carolina before moving back home to Florida in 2015.

The 21-year-old Mariano upset Democratic incumbent Amanda Murphy last fall to become the youngest person ever elected to the state House. She won by 732 votes, or .6 percent.

Murphy had held the seat for three years. She won the seat in a special election in 2013 after then-incumbent Mike Fasano left the seat to take over as tax collector and she easily won re-election in 2014.

But, in what some analysts called a “Trump tsunami,” Mariano was aided by a surge of support for Republican presidential candidate Donald Trump. Trump defeated Hillary Clinton in Pasco County by 21 percentage points, 58 percent to 37 percent.

Jack has been a member of “Indivisible Pasco,” an anti-Trump group organized earlier this year in Pasco County. She calls herself a Democrat with an independent streak, with a progressive stance on most issues but a fiscal conservative.

“I’m new to politics but not to public service,” she says.

Scott Furhman will not seek rematch against Ileana Ros-Lehtinen in CD 27

South Miami Democrat Scott Fuhrman now says he will not be running for the congressional seat being vacated next year by Ileana Ros-Lehtinen.

Fuhrman lost to Ros-Lehtinen last fall by 10 percentage points, 55 to 45 percent, and announced two months ago that he would again challenge the 28-year GOP incumbent in 2018.

Ros-Lehtinen surprised the South Florida political world in late April when she announced that she would not run for re-election next year. The seat was already being targeted by the Democratic Campaign Congressional Committee for 2018, as Hillary Clinton defeated Donald Trump there by nearly 20 points.

In 2016, Ros-Lehtinen aggressively campaigned against Fuhrman, a first-time candidate who entered the race only five months before Election Day. She made Fuhrman’s criminal record a focal point in the race, specifically a 2009 arrest in Colorado for driving under the influence with a loaded handgun in the car. Fuhrman later pleaded guilty, performed community service and paid a fine.

Ros-Lehtinen spent a majority of her $3.4 million campaign account on the 2016 race, while Fuhrman spent about $900,000, most of which self-funded. However, Fuhrman, who had been in charge of his family’s Allapattah juice-bottling company until the campaign, could not overcome Ros-Lehtinen’s near universal name recognition in her district.

While the Democrats will go all out to try to win the seat, Fuhrman will be watching from the sidelines next year.

POLITICO Florida first reported Furhman’s withdrawal.

Bob Buckhorn crosses party lines to help Shawn Harrison’s bid for re-election

In 2016, Democrats targeted a handful of Florida House districts they believed they could flip from red to blue.

One of them was Hillsborough County’s House District 63, where the Florida Democratic Party put some money behind Lisa Montelione in her bid to oust Republican incumbent Shawn Harrison.

After a close race, Harrison ultimately prevailed, 51 to 49 percent.

Although off-year elections are traditionally harder for Democrats, there is hope that an energetic resistance to Donald Trump could make 2018 a year of opportunity.

But as Harrison already begins looking forward to getting re-elected next year, he’s getting assistance from one of the biggest Democrats in the region, Bob Buckhorn. The Tampa mayor is listed as a special guest at Harrison’s June 29 campaign kickoff fundraiser at the Tampa Theatre.

“I support people who support the City of Tampa and our legislative issues,” Buckhorn told FloridaPolitics.com in a text message. “Shawn has consistently been willing to advocate on behalf of issues that were important to the City, even if it meant going against their leadership of his own party. He never forgot what it was like to be a local elected official and has been a voice of reason in a political party that has made local government a target. It seems to me that we are all better served when our elected officials care more about their community that their political issues.”

Harrison has voted against the majority of his party in a few notable cases, such as when he supported a hybrid version of Medicaid expansion a few years ago. He also supported economic incentives for Enterprise Florida, a position Buckhorn backed and which earned him the public rebuke of Governor Rick Scott at an appearance at MOSI early this year.

As House Minority Leader, Tampa state Rep. Janet Cruz was charged with attempting to get as many Democrats elected to the House last fall. She’s also close with Buckhorn and had no issue with him backing Harrison.

“Nothing new,” Cruz told FloridaPolitics.com. “Buckhorn served for many years with Harrison on Council. I believe they became good friends then.”

With Americans saying that they’re tired of partisan bickering, some would say the Buckhorn-Harrison connection should be celebrated. However, that’s not the way some Tampa Democrats see it.

“Flabbergasted” was the term used by Hillsborough County Democratic Executive Committee Chair Ione Townsend after learning of the Mayor’s efforts.

“I’m disappointed because the mayor claims he’s a good Democrat,” said Hillsborough County Democratic Committeeman Russ Patterson, adding that he’s aware that Buckhorn and Harrison are friends. “Friendships are allowed to cross party,” he added.

“I’m not surprised,” said public relations executive Tom Hall, who teamed up with former Chief Financial Officer Alex Sink and others last year to form The Hillsborough Society, which raised over $40,000 to support local Democrats in Hillsborough County in 2016 and is actively recruiting candidates for 2018.

Hall cited Buckhorn’s support for Republican Pam Bondi against Democrat George Sheldon in the 2014 attorney general’s race, and his refusal to back Democrat Charlie Crist in the gubernatorial race that same year as moves that Democrats haven’t forgotten about.

“I think that those two were big mistakes, and the Democrats that I know and talk to have not forgiven him for that,” said Hall, adding that his group is looking for a good Democrat to challenge Harrison in 2018.

Buckhorn won’t be the only elected Democrat from Tampa at the Harrison fundraiser. City Councilman Frank Reddick is also listed on the fundraising announcement. Reddick endorsed Harrison over Montelione last year.

Montelione did not return a request for comment.

GOP running out of time for legislative achievements

President Donald Trump and his GOP allies on Capitol Hill have made it through nearly half their first year in power without a single major legislative achievement. If that’s going to change, it will have to start soon, a reality that Republican lawmakers will confront when they return to the Capitol on Monday from a weeklong break.

“We just need to work harder,” the second-ranking Republican senator, John Cornyn of Texas, said in an interview with KFYO radio in Lubbock, Texas, over the recess.

For now, the party’s marquee agenda items remain undone, their fate uncertain. The long-promised effort to overturn former President Barack Obama‘s health law hangs in limbo in the Senate after barely passing the House. A tax overhaul that’s a top Trump priority is unwritten and in dispute, despite his recent claim on Twitter that it’s ahead of schedule.

“The president keeps saying the tax bill is moving through Congress. It doesn’t exist,” House Minority Leader Nancy Pelosi, D-Calif., said mockingly on Friday. “It doesn’t exist. There is no tax bill moving through Congress.”

Lawmakers will deal with those issues and more as Congress comes back into session, and realistically the window for action is closing fast. Seven legislative weeks are left before Congress scatters for a five-week August recess, a period when lawmakers are likely to lose momentum if they have failed to act on health care or taxes, and face GOP voters frustrated that they haven’t delivered.

Both issues are enormously difficult challenges, and the tax legislation must follow, for procedural reasons, passage of a budget, no small task on its own.

On top of it all, lawmakers are way behind on the annual spending legislation needed to keep the lights on in government. They were recently informed by Treasury Secretary Steven Mnuchin that they will have to raise the federal government’s borrowing limit before August, a daunting task ripe for brinkmanship.

Looming over everything is the investigation into allegations of Russian meddling in the 2016 campaign and connections with the Trump campaign. That investigation is in the hands of a special prosecutor and Congress’ intelligence committees. Former FBI Director James Comey, who was fired by Trump, is scheduled to testify before the Senate committee on Thursday.

“The Russia investigation takes a lot of oxygen, it takes a lot of attention,” said Republican Rep. Tom Cole of Oklahoma, a veteran lawmaker.

Cole argued that Republicans have not gotten the credit they deserve to date for what they have accomplished: voting to overturn a series of Obama regulations, as well as reaching compromise last month on spending legislation for the remainder of the 2017 budget year that included a big increase for defense. The biggest bright spot for the party and for Trump remains Senate confirmation in early April of Supreme Court Justice Neil Gorsuch, whose elevation goes far to placate conservatives frustrated with inaction on other fronts.

“I think we’ve done more than we’ve gotten credit for, but the big ones are ahead,” Cole said. “It’s certainly an ambitious agenda we’ve got, there’s no question about it, it has been all along and I wouldn’t have it any other way.”

Historically, Capitol Hill has been at its busiest and most productive in the early days of a new president’s administration, during the traditional honeymoon. But with his approval ratings hovering around 40 percent, Trump never got that grace period, and although his core supporters show no signs of abandoning him, he is not providing the focused leadership usually essential to helping pass major legislation.

Within Obama’s first 100 days in office, he had signed a large stimulus package as well as equal pay legislation and other bills. An active Congress under President George W. Bush had made progress on campaign finance legislation and bankruptcy changes, among other issues.

In the Senate, Republicans’ slim 52-48 majority gives them little room for error on health care and taxes, issues where they are using complicated procedural rules to move ahead with simple majorities and no Democratic support. Trump’s apparent disengagement from the legislative process was evident this past week when he demanded on Twitter that the Senate “should switch to 51 votes, immediately, and get Healthcare and TAX CUTS approved, fast and easy.”

In fact, that’s exactly how Republicans are already moving. But the trouble is within their own ranks as Senate Republicans disagree over how quickly to unwind the Medicaid expansion under Obama’s health law, as well as other elements of the GOP bill.

Addressing the health legislation, Cornyn pledged on KFYO, “We’ll get it done by the end of July at the latest.” Despite that show of optimism, there’s uncertainty aplenty over whether the Senate will be able to pass a health bill, and whether a complicated tax overhaul or even a simple set of tax cuts will advance.

For some Republicans, their sights are set on the more immediate and necessary tasks of completing the annual spending bills that are needed to avert a government shutdown when the budget year ends Sept. 30, and on raising the debt ceiling to avert a first-ever default.

“It’ll be more difficult than it should be,” said GOP Rep. Charlie Dent of Pennsylvania, a senior member of the House Appropriations Committee. “Because Congress is what it is.”

Republished with permission of The Associated Press.

Does Donald Trump believe in climate change or not? Aides won’t say

Does he or doesn’t he? Believe in climate change, that is.

You’d think that would be an easy enough question the day after President Donald Trump announced he was pulling the U.S. out of the landmark global accord aimed at combating global warming.

But don’t bother asking at the White House.

“I have not had an opportunity to have that discussion” with the president, responded Press Secretary Sean Spicer on Friday.

“You should ask him that,” offered White House Counselor Kellyanne Conway.

Environmental Protection Agency chief Scott Pruitt dodged the question, too.

The president also ignored it during an unrelated bill-signing.

It’s quite a reversal for Trump, who spent years publicly bashing the idea of global warming as a “hoax” and “total con job” in books, interviews and tweets. He openly challenged the scientific consensus that the climate is changing and man-made carbon emissions are largely to blame.

“Global warming is an expensive hoax!” he tweeted in 2014.

But Trump has been largely silent on the issue since his election last fall. On Thursday, he made scarce mention of it in his lengthy remarks announcing America’s exit from the Paris accord. Instead, he framed his decision as based on economics.

Here’s what he’s said before:

TRUMP’S TWEETS:

The president’s Twitter feed once was filled with references to “so-called” global warming being a “total con job” based on “faulty science and manipulated data.”

An Associated Press search of his Twitter archives revealed at least 90 instances in which he has referred to “global warming” and “climate change” since 2011. In nearly every instance, he expressed skepticism or mockery.

“This very expensive GLOBAL WARMING bulls— has got to stop,” he wrote in January 2014, spelling out the vulgarity.

Often the president has pointed to cold weather as evidence the climate scientists are wrong.

“It’s 46 (really cold) and snowing in New York on Memorial Day — tell the so-called “scientists” that we want global warming right now!” he wrote in May 2013 — one of several instances in which he said that warming would be welcome.

“Where the hell is global warming when you need it?” he asked in January 2015.

The same message was echoed in the president’s books.

In “Great Again: How to Fix Our Crippled America,” Trump made a reference to “the mistaken belief that global climate change is being caused by carbon emissions.”

“If you don’t buy that — and I don’t — then what we have is really just an expensive way of making the tree-huggers feel good about themselves,” he wrote.

CANDIDATE AND SKEPTIC:

“I’m not a believer in man-made global warming,” Trump told conservative radio host Hugh Hewitt in September 2015, after launching his bid for the White House. He bemoaned the fact that the U.S. was investing money and doing things “to solve a problem that I don’t think in any major fashion exists.”

“I am not a believer,” he added, “Unless somebody can prove something to me … I am not a believer and we have much bigger problems.”

By March 2016, the president appeared to allow that the climate was changing — but continued to doubt humans were to blame.

“I think there’s a change in weather. I am not a great believer in man-made climate change. I’m not a great believer,” he told The Washington Post. “There is certainly a change in weather,” he said.

Then-campaign manager, Conway explained Trump’s view this way: “He believes that global warming is naturally occurring. That there are shifts naturally occurring.”

EVOLVING PRESIDENT:

In an interview with The New York Times in November, after the election, Trump was asked repeatedly whether he intended to leave the Paris accord and appeared to have a new open-mindedness.

“I’m looking at it very closely,” Trump told the newspaper. “I have an open mind to it. We’re going to look very carefully.”

He went on to say that he thought “there is some connectivity” between human activity and the changing climate, but that, “It depends on how much.”

Asked about the comment several days later, Trump’s now-chief of staff Reince Priebus told Fox News that Trump “has his default position, which is that most of it is a bunch of bunk.”

“But he’ll have an open mind and listen to people,” he said.

Stay tuned.

Republished with permission of The Associated Press.

Joe Henderson: Bob Buckhorn says Tampa will join other cities honoring Paris Climate Accord goals

The pushback from mayors all over the country began almost immediately after President Donald Trump announced the United States will no longer honor its commitment to the Paris Climate Accord.

Medium.com reported Friday morning that 83 mayors from around the country have said they will commit their cities to following the goals that agreement, despite the President’s decree.

They signed a letter promising: “ … we will adopt, honor, and uphold the commitments to the goals enshrined in the Paris Agreement. We will intensify efforts to meet each of our cities’ current climate goals, push for new action to meet the 1.5 degrees Celsius target, and work together to create a 21st-century clean energy economy.”

Five of the mayors represent Florida cities: Van W. Johnson of Apalachicola, Richard J. Kaplan of Lauderhill, Philip Levine of Miami Beach, Buddy Dyer of Orlando, and Rick Kriseman of St. Petersburg.

Although he wasn’t included on that list, Tampa Mayor Bob Buckhorn told me via text message he, too, will commit to having his city join that effort.

“Although the Paris Accord is more global in nature, every city has the ability to create policy that is appropriate for their particular jurisdiction,” Buckhorn said.

“Some cities are further along than others in developing comprehensive plans and metrics and there is always room to improve. This action by the POTUS is certainly an incentive to further refine those plans.”

Trump’s decision to pull out of the agreement has been widely panned around the world and at home — even in Pittsburgh, which the president held up as a reason for taking the action. The place once known as the “Steel City” for its reliance on that industry has transformed itself into a diversified center for medicine, banking, and technology.

In an interview on CNN, Pittsburgh Mayor William Peduto said of Trump, “What you did was not only bad for the economy of this country but also weakened America in this world.”

The issue of climate change is especially sensitive to Florida cities. Continued rising sea levels threaten coastal cities, and scientists say the risk of more numerous and powerful hurricanes is increasing.

Because of that, Buckhorn said, “ … all of our efforts will be accelerated. We will continue to lead.

“We are increasing investments in renewable energy and energy efficiency.  From lowering our carbon footprint, investing in equipment that uses renewable energy and trying to attract and grow clean energy jobs, Mayors can and should lead the way.”

Lenny Curry: Paris Accord ‘has no teeth to it’

Breaking with most big city mayors that have thus far opined on President Donald Trump withdrawing from the Paris Accord: Jacksonville Mayor Lenny Curry.

campaigned on American jobs, cutting regs that killed those jobs &he won.He’s doing what he said he would do. ,” Curry Tweeted Thursday evening.

Curry, during a press conference Friday morning discussing summer camp funding, explained his Tweet, which he said “spoke for itself.”

“I didn’t take a specific position,” Curry said about the Paris Accord, saying his Tweet was a “general statement of support” for Trump’s actions.

Rather, Curry supports President Trump’s commitment to “American jobs.” But he did outline qualms with the agreement itself, including no obligation imposed on China until 2030, which means “13 years on the backs of American workers.”

And other European countries, Curry said, are seeing their emissions go up, even as American emission levels decrease.

The Paris Accord, Curry added, “has no teeth to it.”

We asked Jacksonville City Council President-Designate Anna Brosche her take on Curry’s Tweet on Thursday evening. She said she had “no opinion”, as she was “focused on local politics.” Democratic Councilors, such as Reggie Brown and Katrina Brown, likewise were less than specific.

One City Councilman who was willing to take a position: Curry’s fellow Republican, Councilman Jim Love.

Love, a believer in climate change, said it was “shortsighted … to pull out of the whole thing,” even as some points need revision, as “Florida will bear the brunt” of climate change.

Curry has been willing to fly in the face of seeming scientific consensus on climate change issues before.

Curry drew criticism in 2016 for leaving the Rockefeller Foundation’s 100 Resilient Cities initiative, which offered $1M grants for city-level actions against climate change.

As Jacksonville deals with flooding, as it has this week, expect that at least some out there will demonstrate chagrin at Curry’s aligning with President Trump on this issue.

Curry has already exchanged banter with local media on Twitter, which he saw as editorializing on this matter.

Former Hillsborough Judge Ashley Moody launches bid for Attorney General

Ashley Moody, who served a Hillsborough judge for more than a decade until resigning abruptly in late April, has filed as a Republican candidate for Attorney General.

Moody was elected to the 13th Judicial Circuit in 2006 at the age of 31, becoming the youngest judge in Florida.

Moody is a 1996 graduate of the University of Florida and received her J.D. degree from the UF College of Law in 2000.

She is the daughter of longtime federal judge James Moody Jr.

Another important note, Moody has already lined up GOP heavyweight Nancy Watkins to serve as her campaign treasurer.

Florida’s current Attorney General is Pam Bondi, who many speculated would join the Donald Trump administration. She is term-limited from running again.

Moody is the second Republican to enter the race. Jacksonville state Representative Jay Fant filed last month. On the Democratic side, Hillsborough County Attorney Ryan C. Torrens announced his candidacy last week.

 

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