I've had 2 open heart surgeries and skipping the pain killers was not an option. The first one I had in 2004 and was sober at the time, but I was not in a good place mentally and was doing little to nothing for my recovery. I had a complication with my sternum which required me to stay on opiates for a few months. I got addicted to them, and after the sternum complication was resolved and my surgeon stopped the opiates I continued to find and take them from alternative sources for over a year. I also started drinking again as the opiates became harder to attain and it led to an 8 year relapse that almost killed me.
I was actively drinking during my 2nd surgery in 2011 and had no problems with the painkillers. I was completely off of them within a week of being discharged from the hospital. I'm not sure what the lesson is from my experiences except that the first time it led me back to drinking, and the 2nd time I was already drinking plus I had the advantage of knowing what happened after my first surgery.