Pain control in pt. With hx of opiate abuse

I noticed that some patients have this severe chronic pain with history of opiate abuse have a lot of trouble getting pain control in the hospital. Sometimes, I feel like physicians don't listen to them enough. I feel like doctors (including the pain team !) usually go with a pharmacological approach to pain control but once they have all these non opiate pain medicines on board, they get a teeny amount of opiate or none at all and then they are on their own. I even struggle trying to get consults for people sometimes and get responses like "well they broke their pain contract in the past." I think people with severe uncontrolled pain (and often psych comorbidities) are very likely to break pain contracts so they can go get illegal drugs to get some relief for a minute. The system is pretty unforgiving of those situations. If they don't get enough support they will likely go back to using again. It's a vicious cycle. I feel like we should try harder. I also hardly ever hear of alternative therapies such as accupuncture and we seem to forget to get psych or stress management involved. This is one of the few areas where I find myself having to really strongly advocate for people. Anyone else have this dilemma ? What more can I do for this population?