While overprescription of opioids for a vast majority of Americans is causing tolerance, opioid use disorder, abuse, and overdose, is there a small subset of Americans whose pain is vastly undertreated? Over the past half decade, literature has illuminated major discrepancies in the diagnosis and treatment of acute and chronic pain in many disadvantaged and underrepresented groups. This course will summarize and explore our knowledge of discrepancies in opioid prescribing based on race, class, and gender, and whether these disadvantaged groups are undertreated or if majority groups are overtreated with opioids. We will also explore the potential reasons behind these discrepancies, and look for solutions.