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Tuesday January 27, 2015
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Treating addiction and pain



Trim, with salt-and-pepper hair and a white lab coat, Malinoff, fifty-seven, looks like a TV doc. A U-M undergrad and med school grad, Malinoff did fellowships in oncology and nuclear medicine but now specializes in chronic pain, addiction, and detoxification. He's a faculty member at the U-M's Back and Pain Clinic, an attending physician at St. Joe's, and has his own clinic, Pain Recovery Solutions, in Ypsilanti.

Malinoff says a third of his patients suffer various sorts of chronic pain, including fibromyalgia, pelvic pain, headaches, and irritable bowel. Another third have a chemical dependency to alcohol, nicotine, prescription medications, or street drugs. And the remaining third are battling both chronic pain and chemical dependency or addiction.

"The patients I take care of are the ones other doctors don't want to take care of," Malinoff says. "They drive other doctors crazy."

The key to his approach, Malinoff says, is identifying something called comorbidity: the presence of one or more disorders or diseases in addition to the patient's primary complaint. Malinoff grabs a piece of paper, warns that he's a lousy artist, and draws four overlapping circles. He labels them chronic pain, psychiatric illness, medical illness, and addictive illness.

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