What do they do in Europe, where gas has consistently been >$6/gal? I bet the answer involves diesels, compact cars towing things Americans "need" a truck to tow, vans, and using the smallest truck necessary for the job.
In Germany, you can get a Mercedes-Benz Sprinter pickup:
Mercedes-Benz Deutschland - Technische Daten - Maße & Gewichte
If you select the 4 cylinder diesel with the six speed stick, you get 29mpg on the Euro combined cycle, and a 2200lb payload capacity. Go with a big V6 gasser, and you get an unimpressive 18mpg.