This article offers a longitudinal computational-rhetorical analysis of biomedical writing on opioids. Using a corpus of 1,467 articles and essays published in the New England Journal of Medicine and the Journal of the American Medical Association between 1959 and May 2019, this study evaluates diachronic shifts in (a) the framing of opioid pharmacology, (b) the relative attention paid to pain management versus opioid dependence risks, and (c) the distribution of statements related to physicians’ primary ethical obligations. The results of these analyses largely disconfirm different current accounts of shifting physician rhetoric around opioids and pain management leading up to the recognition opioid epidemic. Most notably, the results also suggest that biomedical debates surrounding opioids are serving as proxy arguments for shifting primary bioethical obligations from individual patients to public health.

本文提供了关于阿片类药物生物医学文字的纵向计算-修辞分析。使用在《新英格兰医学杂志》和《美国医学会杂志》上发表的1467条文章和论文的语料库在1959年至2019年5月之间，这项研究评估了（a）阿片类药物药理学的框架，（b）对疼痛管理与阿片类药物依赖风险的相对关注以及（c）与医生的主要伦理相关的陈述的分布的历时性变化义务。这些分析的结果在很大程度上证实了当前关于阿片类药物的医生论调的变化和导致阿片类药物流行的疼痛处理的不同说法。最值得注意的是，研究结果还表明，围绕阿片类药物的生物医学争论正在成为将主要生物伦理义务从个体患者转移到公共卫生的代理论据。