My suggestion to you would be that if your pain doctor is no longer helping you, seek a new one! That's what I had to end up doing. I was seeing him for over two years, and he gave me nerve blocks which of course didn't work for me, along with trigger point injections (which he wasn't doing correctly). I would see him once a month to get my scripts and he would spend all of 5 minutes with me, ask me how I felt (which was the same every time I saw him) and said he'd see me in 4 weeks. I was getting nowhere. He didn't suggest anything new.
There has to be a valid reason your doc isn't giving you these patches. Maybe they'd react to your other meds? If not, find out why he won't give them to you. I've been on the patches for over two years and started with 25mcg, then he moved me up to 50mcg. My new pain doc, on my first visit with him bumped me up to 75mcg. Unfortunately for my pain, they still don't help. My problem is Occipital Neuralgia and the pain is really deep into the base of my skull. The patches might work for you, though.
The best of luck to you. Remember though, if you're not getting anywhere with this doctor, seek a new one. That was the best thing I could have done. After four years of suffering, he is the first one to give me a diagnosis.