Much of the issue arises from the inherent rod position during high-sticking IMHO. In order for the rod to get loaded, apply tension, overcome the current, and stick the hook it has to be almost behind you with that starting position.
I am by no means a high-stick expert but I would think that using a stripset to the side with the line hand starting high near the stripper would be the best best, and also set to the downriver side to get the belly of the line pulling the fly to the corner of the mouth.
I would also use a fairly large gape light wire hook in this case as well since the 'greaseline' method of setting downcurrent is being employed, or potentially being employed I should say.
I would also pinch the barb for better penetration, but then again I pinch all my barbs.
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