Age, alcohol use and hair color can affect surgery pain meds

Age, alcohol use, hair color, medication history and substance use can all shape how much anesthesia and pain medicine you need. The cleaner path is to tell the anesthesiologist what affects your body before the first incision.

Postoperative pain is not treated with a one-size-fits-all formula. In practice, care teams often use more than one medicine class and add non-drug measures so pain is controlled without leaning too heavily on opioids.

Why the pre-op conversation matters

If you are preparing for surgery, the anesthesiologist needs a full picture of what is going on in your body before sedation starts. The Washington Post highlighted several factors that can change anesthesia needs, including age, alcohol use and hair color.

Michigan OPEN, a pain-management initiative focused on safer prescribing, recommends that surgery pain planning begin before the operation with counseling about recovery expectations and the first-line medicines likely to be used. That means the visit before surgery is where the team decides whether your pain plan should lean toward acetaminophen, an anti-inflammatory medicine, an opioid, or a combination.

What to disclose before surgery

Several details belong on the table well before the procedure begins:

• Your age, because anesthesia and pain needs can shift across age groups • Alcohol use, including how much and how often you drink • Any history of risky substance use, which can affect surgery pain management needs • All current and recent medications, including prescription drugs, over-the-counter pain relievers and supplements • Any prior problems with anesthesia, severe nausea, difficult pain control or unexpected drug reactions • Family or personal traits that may matter to the anesthesiology team, including the hair-color clue highlighted in the Washington Post piece

That information helps clinicians avoid under-treating pain and exposing you to more opioid than you need.

How surgeons and anesthesiologists personalize pain control

Mayo Clinic and Cleveland Clinic both describe postoperative pain care as individualized. Pain medicines after surgery can include acetaminophen, nonsteroidal anti-inflammatory drugs and opioids, depending on the procedure and the patient.

That is where multimodal pain control comes in. Instead of relying on one drug to do all the work, clinicians combine therapies so each one can cover part of the pain response. The result can be lower opioid exposure, fewer side effects and better function in the hours and days after surgery.

The American Academy of Orthopaedic Surgeons’ OrthoInfo tells patients to understand how their medicines work and to coordinate closely with the care team so they use each medication correctly rather than improvising after discharge.

Why opioids are not the default answer

The American Society of Anesthesiologists has warned that opioids are often not the answer to post-surgery pain and discomfort.

In a 2024 news release, the ASA said Black patients were less likely to receive multimodal pain-management options after surgery.

Earlier ASA messaging noted that patients often overestimate how much pain they will have after surgery. That misconception can drive fear, which in turn can influence how people discuss medication, recovery and opioid use with their clinicians.

What a safer pain plan usually looks like

For many procedures, the plan begins before surgery and continues after discharge. Michigan OPEN emphasizes preoperative medication counseling and realistic recovery expectations, because pain management works best when patients know what medicines they will take, when they will take them and what level of discomfort is expected.

A common approach includes:

• Acetaminophen for baseline pain control • NSAIDs when appropriate for inflammation and pain • A limited opioid prescription if the operation or pain severity justifies it • Non-drug strategies such as ice, movement guidance, rest positioning or physical therapy instructions, depending on the procedure

The plan should match the operation and the person. A minor procedure may not need the same medication mix as orthopaedic surgery, and a patient with a history of substance use or a strong reaction to sedating drugs may need a different strategy altogether.

Where policy has pushed practice

Washington state moved early on postoperative opioid prescribing. Supplemental guidance from the Bree Collaborative and the Washington Agency Medical Directors’ Group was adopted on July 17, 2018, and was developed in response to the opioid crisis.

Guidance from state groups, medical societies and major health systems points in the same direction: collect better information before surgery, use multiple tools after surgery and reserve opioids for cases where they are truly needed.