Lying about pain, but not how you’d think

I’m really bad at advocating for pain management and I’ve had some traumatic experiences because of it. For example, once I was sent to the ER for a flare of 10/10 abdominal/nerve pain from MALS and them just giving me a high dose sedative that made me suicidal and unable to move or communicate without any pain meds, so I was just in excruciating pain for hours when they thought I was unconscious. They finally gave me meds when they realized I was conscious but it was just 10 of oxy which did literally nothing, and then after they gave me another 10 and it still did nothing I just lied and said my pain was better since I realized they weren’t going to help me. Anyone else struggle with doing this kind of thing, lying instead of advocating?

The only med I’m on now is 600mg TID of gabapentin, which does help some with the less severe constant pain, bringing it down from a 6-7 to a 4-6, but I still get spikes in the 8-9 range almost daily which nothing has ever helped with, besides fent and oxy a tiny bit at 20mg+ doses, both of which I’ve only really had after surgeries, which feels silly since my surgical pain is so much less severe than my normal, daily pain. I just don’t know how to talk to my doctors about this stuff. I’m trying all the non-medication stuff, doing lots of PT, exercise, CBT, heating pads, ice packs, TENS, lidocaine, CBD, menthol, and even a wheelchair. All of which help to improve my baseline level of pain, but still barely help for those big spikes. Any advice would be much appreciated