This study employs corpus-based discourse analysis to investigate racial and gender disparities in opioid prescribing practices. Analysis of 171 medical interactions in the United States from 2008 to 2020, drawn from the Verilogue corpus of doctor-patient dialogue, revealed a significant relationship between patients’ race and physicians’ prescribing behaviors. By systematically examining the stages in which patients were either prescribed or denied opioids, this study quantifies the challenges faced by patients as they navigate opioid-related discussions. 

Statistical analyses revealed that patient race was significantly associated with whether patients were prescribed and offered opioids, while gender did not show any significant association. Logistic regression analysis revealed that racial and ethnic minorities (REMs) had significantly lower odds of being prescribed opioids for their pain. REMs were also less likely to be offered opioids, resulting in them having to initiate requests for this fraught medication.

Discourse analysis of excerpts is provided to offer deeper insights into these disparities, highlighting patterns of increased scrutiny and hesitance in prescribing opioids to REM patients, even when they reported severe pain. In contrast, interactions with White patients often demonstrated more relaxed prescribing practices and increased patient autonomy in treatment decisions. These findings align with current research on inequities in pain treatment across communities. By illuminating these disparities, this research emphasizes the importance of understanding various culturally-dependent linguistic practices, such as the diverse ways individuals express pain.