I am all about someone being treated fairly and accordingly to address pain issues and for MAT. However both routes of treatment need to have their own limits and both need to find a therapeutic baseline as quick as possible. Increasing dosages rapidly does to allow a doctor to accurately gauge a treatment plan.
The approach to pain management is treating the patient's pain and allowing room to grow & allowing room to treat acute pain and breakthrough pain. The idea of treating pain 80-100% free is not realistic. The brain needs fluctuation on the mu, kappa, and Delta receptors in order to truly manage chronic pain. The opioid buffet approach wears out fast and the patient is left with medicine that does not work.
The approach to treating OUD is similar to pain management but their are misconceptions I believe are created at the MAT clinic. Patients dealing with chronic pain, cancer pain, and chronic pain syndrome get different effects from the narcotics compared to many MAT patients. When the brain is "not on guard" from the absence of consistent pain, narcotics have more euphoria and side effects. The MAT clinic does not educated patients on MME and are not efficient in developing an understanding of how much narcotic is needed to control physical dependency.
Being overly sympathetic and increasing dosages for "urge control" or not being in the state of 100% happiness, is not helping the patient. Even in pain management, the patients desire for more narcotic, we are sick & tired of chronic pain, our bodies & minds never feel up to par, and basically fall in line with OUD because of dependency and feeding the brain's never-ending reward seeking.