I avoid opioids as much as possible. However, with Factor V Leiden if I have surgery I can't take any NSAIDs (besides Tylenol) due them also being blood thinners and post surgery I'd also be on Lovenox. And, for me, Tylenol (at doses that can be safely taken) doesn't touch pain, even mild pain like a pulled muscle, or sore joint, or headache. But I'm also allergic to most opioids I've ever tried. So I'm kind of screwed if I need major pain relief like from a surgery.