So I had pretty major surgery at around 8 months sober (coming up on 4 years in March). I had both my hips replaced due to avascular necrosis caused by my drinking. I was 31 at the time.
Here's how I got through it:
1. I was upfront with every single doctor and nurse I interacted with that I was in recovery. I probably got a little annoying with the constant reminders, but it was good to have everyone on the same page. The hospital even set up a "pain management" team for me.
2. I had to learn the hard way that sometimes opioid medication is unavoidable. After the surgery, I was still under the effects of the general anesthesia, as well as the epidural that I had. I felt okay, so I got overly confident that I could get through my initial surgical recovery without the pain meds. After I was moved off the surgical floor to the general recovery floor, I closed my eyes for some sleep, only to wake up screaming at 3am from some of the most intense pain I've ever experienced. I learned very quickly that I had to stay ahead of the pain with my meds.
3. After a few days in the hospital, I checked into an inpatient physical rehab for a week. My insurance gave me the option of having a nurse come to my apartment a few times a week, but I chose the rehab because the on-site doctors and nurses were completely in charge of my pain meds so there was no way I could take more than prescribed.
At this point, I was on morphine and oxycodone. I had used a lot of drugs when I was in my early 20s, but not opiates. However, I recognized that I could become addicted to pretty much anything, so I didn't want to take any chances. The nurses here all knew I was in recovery and took good care of me. Plus the 3-4 hours of a day of intense physical therapy got me started out on the right track.
4. I then went back to my apartment. I gave all my pills to a family member who lived close by and was not an addict/alcoholic. The family member dished out the required meds for only a couple of days at a time so I wouldn't have the entire bottle staring me in the face. I started outpatient physical therapy three times a week.
5. Once I was ready in terms of diminished pain (about 4 weeks after the surgery), I worked directly with my primary care doctor to come up with a concrete taper plan to get off the pain meds. I was off everything except Tylenol and Advil within 6 weeks of my surgery. I ended up flushing a good amount of pills down the drain. My physical withdrawals were minor and nothing compared with what I went through to detox from alcohol.
6. I relied heavily on my recovery support network. My sponsor visited me regularly when I was in the inpatient rehab. My friends brought AA meetings to me at the rehab and to my apartment (the rehab was kind enough to let us use the cafeteria at night for meetings). My friends brought me homemade food, kept me company, and read AA literature with me. I wouldn't have been able to get through the experience without them. I still remember everyone crowding into my tiny city apartment and having impromptu AA meetings followed by potluck dinners. They kept me focused on not just my physical recovery by on my mental and spiritual recovery as well.
7. Along the same lines, I read and posted a lot on SR, especially within my March 2013 class. I found people here who had gone through the same surgery and they shared their experience, strength and hope.
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I'll be honest, the pain meds definitely did a number on my brain. I could clearly identify the familiar addictive thought process of taking something external to feel better internally and how easily it was to make the pain (and all my thoughts, fears, and feelings) just "go away." I could have easily gone down the deep end if I wasn't so regimented about everything. I've known people who have gone back out after 20 years of sobriety over something like pain meds after getting a tooth pulled or getting into a car accident. Don't get me wrong, pain meds are absolutely necessary in some cases, but they are not to be taken lightly.
Good luck to you!