OP had a regimen that was working for her. A regimen that was arrived at by her first doctor that was a pain management specialist. In comes a new doctor who is NOT a pain management specialist and throws out all the work done to get her to a livable state. So she did have a pain management doctor who retired.
The CDC did not say to throw out effective treatments that include opiates but to work up to them if necessary, to use the lowest dose possible, to dispense immediate release and not the long acting or extended release and to use urine drug screens at least yearly. Before a patient is accepted into pain management we have already tried all the other treatments, physical therapy, TENS units, radio wave ablations, steroid injections, muscle relaxers, Gabapentin, and others. When we go to pain management we are desperate and feeling more than a little isolated by the very things you wrote. We are not numb, we are not pain free, we are able to get out of the bed and take care of our family, cook, clean, take showers, and for some able to work. We are tired of the stink eye we get when our scripts are filled, we are tired of all the world thinking we do not deserve pain relief. Been there, done that, got the t-shirt multiple times.
I cannot walk into a physical therapy room now if I wanted to - latex. I had nerves relocated to help reduce the pain - moderate relief. I have had ablations on nerves without success, I still have pain bad enough that making it to the bathroom is an olympic sport for me. I started with 5/325 and now am on 10/325 4 times a day. I take Zanaflex for the muscles, I am no where near pain free. Tried TENS and other stimulating units but no more - allergies. I have had 2 surgeries on my c-spine but no surgeon will take me on now. Disks in the lower back collapsing, one nerve pinched off now with another going - no surgery in my future - latex - I am too risky now. We have had a short discussion on the next step up and I refused. I do love the fact that so many people think buprenorphine is not an opioid, not addictive and safe. It is highly addictive, recommended for the opioid experienced only and is currently being doled out like Oxy once was. I also love that a medication that has been on the market since the 80's is not generic yet with no sign of generics show up soon and no insurance coverage. Middle of the dose is just over 500/month out of pocket.
"We need to rethink our pain". Just how is someone supposed to "rethink" pain? What happened to pain is what the patient say it is? "Maximizing multimodal therapies as well as holistic approaches need to be explored and tailored to individual patients" and that is what pain management doctors do, they find what works for each individual patient and I do not think the CDC and DEA should be in that mix.
"If you need opiates, I'd argue your pain isn't being managed and you need a better workup". A better workup? You are sent from the office of the best neurosurgeon in town to the best pain management doctor in town but I need a better workup. I had 4/5/6 fused, a few years later we had to stabilize 2/3 to the previously fused but this time it had to be plates and screws. Recent MRI shows l2/3/4/5 collapsing on themselves due to disk deterioration with one nerve pinched and another being pushed out of place. A better workup? Well we have not done an MRI on any of the thoracic areas where there is pain but I am not talking to the doc about that yet.
I feel for the OP. I am in the same boat but my doc is willing to go to bat for me to keep my medications. Moving to patches is a no go, I react badly to the adhesives. She needed to be sent to a pain management specialist when her original doctor retired. The lack of understanding and compassion for people in chronic pain within the medical community still astounds me. I have also seen the change in doctors and other nurses in regard to pain management after they are suddenly hit with the same type of pain others live with, they seen to always come back more willing to sit and listen to their patients, try treatments that may be outside the box but they are always more willing to provide better pain control than before.
I do not know because the OP did not address this but I have never been high, numb or even pain free since 2005.