Postoperative opioid prescribing: Getting it RIGHTT

Am J Surg. 2018 Apr;215(4):707-711. doi: 10.1016/j.amjsurg.2018.02.001. Epub 2018 Feb 6.


Background: Prescription opioid medications account for a large number of fatal and non-fatal overdoses. Many opioid prescription medications after surgery go unused, with the potential for diversion and misuse. As surgeons become increasingly aware of their role in opioid misuse, better tools are needed to guide behavior.

Data sources: There has recently been a plethora of research into opioid prescribing after surgery. A review of this literature was performed using a search for manuscripts written in the English language. Our goal was to develop an easily recalled approach to postoperative opioid prescribing.

Results: Based on an extensive review of recent literature, we developed the acronym RIGHTT: Risk for adverse event, Insight into pain, Going over pain plan, Halting opioids, Tossing unused opioids and Trouble identification. It is important that surgeons recognize the potential for opioid misuse in their patients. Strategies have been developed to decrease the risk of prescribing opioids. RIGHTT provides a simple acronym for surgeons to integrate best-practice strategies into their management of post-surgical opioids.

Keywords: Non-opioid pain adjuncts; Opioid education; Opioid misuse; Opioid prescribing; Postoperative pain.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Drug Prescriptions / statistics & numerical data*
  • Humans
  • Opioid-Related Disorders / prevention & control*
  • Pain, Postoperative / drug therapy*
  • Practice Patterns, Physicians' / statistics & numerical data*


  • Analgesics, Opioid