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The escalation of the opioid epidemic in the United States has sparked sweeping legislation meant to regulate physicians' opioid prescribing practices. The demands of such policies force physicians to initiate discussions that could jeopardize the collaborative doctor- patient relationships necessary for curbing inappropriate opioid prescriptions. Drawing on sociopragmatics, this discourse

The escalation of the opioid epidemic in the United States has sparked sweeping legislation meant to regulate physicians' opioid prescribing practices. The demands of such policies force physicians to initiate discussions that could jeopardize the collaborative doctor- patient relationships necessary for curbing inappropriate opioid prescriptions. Drawing on sociopragmatics, this discourse analysis study of primary care interactions examines the face- saving linguistic features employed by physicians in negotiating the line between policy demands and maintaining collaborative relationships. The findings reveal several face-saving acts‚"pseudo requests, downtowners, broadening, redirection, tag questions, impersonalization, listing, and (negative) imagery‚"used by physicians when enacting the three most prominent policies: (1) monitoring opioid use, (2) prescribing anti-overdose medication, and (3) transitioning patients from opioids to alternative treatment. Informed by Goffman's concept of "face-work," this study provides evidence of the communicative burden placed on physicians implementing disagreeable opioid policies, as well as opening up discussions on how policymakers and medical institutions can support physicians in implementing opioid policies. Keywords: opioids, face-work, face threats, medical discourse, doctor-patient interaction, discourse analysis, sociopragmatics

ContributorsTorres, Peter Joseph (Author)
Created2023-01-18
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The present study uses corpus-assisted discourse analysis to examine the role of modality in policy verb phrases, using California opioid policies as a case study. By tracking the behavior of permissive and restrictive modals across time, this study highlights two potential discourse functions of modals in policy drafting: (i) to

The present study uses corpus-assisted discourse analysis to examine the role of modality in policy verb phrases, using California opioid policies as a case study. By tracking the behavior of permissive and restrictive modals across time, this study highlights two potential discourse functions of modals in policy drafting: (i) to reflect the gravity of the issues on the ground, and (ii) to express permission and restriction by highlighting and deemphasizing a policy's suggestive intent, respectively. This study shows that the increased use of restrictive modality has significant positive correlations with California's worsening opioid crisis and its rising fatalities. A closer examination of state policy amendments reveals that altering policy modals has the potential to either broaden or limit the terms of existing policies. Informed by Van Dijk's “context models,” this study provides a cogent applied corpus linguistics framework for analyzing policy text and offers both political and linguistic perspectives into our understanding of modals and how communities address epidemics, respectively.

ContributorsTorres, Peter Joseph (Author) / Elsevier Science Ltd. (Publisher)
Created2021-12-15