Interdose restlessness is distinct from the original symptom and worth naming separately.

Same.

Sorry for the basic question, but how do you actually start one of these diaries?

Ten percent cuts, of the current dose not the original. That is the arithmetic that keeps it survivable.

Following this because I am in the same place and have no idea what to ask at the appointment.

Changing prescriber does not reset anything, and people discover that the hard way. Not on harm reduction but the pattern is familiar.

Worth asking what specifically was measured. Pain scores move with mood and function does not.

How do you tell the difference between the drug working and just a good week?

Half of what people describe as tolerance is a change in the underlying condition, and the two need different answers.

Interdose restlessness is distinct from the original symptom and worth naming separately.

How do you tell the difference between the drug working and just a good week?

Same shape here, different drug. The thing that helped was documenting the refusal rather than re-arguing it. They refer rather than write. How long have you been on harm reduction?

Is it normal to feel worse before better? Nobody told me that.

Personal experience, labelled as such, is exactly right here. Nobody is prescribing.