The Crimson Binome
Hero
Surprisingly or not, it doesn't really come up. By the time someone can trivially survive 20d6 damage, they have easy ways of avoiding it, like flight. At least, that's now it's gone down in my historical experience with running 5E games at high levels.So in your “rules as world physics” game, don’t your PCs routinely fall off cliffs only to come back minutes later to try again? Or do you handle falling damage differently than it’s described in the books?
For what it's worth, I do use alternate healing rules, which give me more freedom to describe the traumatic injury associated with taking 70 damage from a fall. Even if the characters can survive it, and they know that they can survive it, nobody wants to deal with the pain.