By Mark Winsberg, M.D
I am the youngest of four kids born to my parents in the span of six years. My father, Cornell-educated with a master’s degree in soil science, was just finding his way into farming in South Florida when I entered the scene.
My mother, also a Cornell student in home economics, had to cut her college career one semester short of graduating when my oldest sister was born.
I still find it hard to fathom how my parents held it together while Dad went from college student to fertilizer salesman, to dairy farmhand, to partner with another farmer and eventually to buying our 300-acre farm, while Mom almost single-handedly raised us four kids.
I was a good student, a good athlete and good at holding my own in almost any social situation. But maybe because I was the youngest child, I came to the erroneous conclusion that I wasn’t and would never be smart enough, strong enough or good enough to truly fit into my family or anywhere else for that matter. Ignoring mountains of evidence to the contrary, I spent much of my life trying to prove that assumption true.
Maybe that’s why my past is made up of such a crazy array of social and work situations.
Like the dog in the kids’ story “Are You My Mother?” it seemed I could never find my place in the world.
I was a farm boy, drove tractors, baled hay, raised cattle and dug ditches.
My playmates were the Black and Puerto Rican farmworker kids on the farm and in town, the lawyers’ and doctors’ kids in the advanced classes at school. I worked on a dairy farm, did house construction, spent two years as a welder-pipefitter, lived in a kibbutz in Israel picking bananas and learning Hebrew.
I went to three different elementary schools, two junior high schools, two high schools, four undergrad colleges, two medical schools (graduated from Stanford Medical School), completed a residency in family medicine and ended up working in and becoming the medical director of a small emergency room outside of Rochester for 17 years.
I did well in every one of those environments, but the loop playing in my head always said, “You’re stupid, you’re weak and you don’t belong here.”
Alcohol and drugs first entered my life when I was about 16.
The self-demeaning brain loop was becoming intolerable when I met Bob, the first-chair drummer in the marching band (I was second chair). Bob invited me to a “church party,” which turned out to consist of meeting in the church parking lot, going to 7-Eleven for dollar bottles of Strawberry Hill, then heading to the beach to get drunk. That kicked off a six-month period of getting stoned at Bob’s house every day before school, getting stoned at rock concerts on the weekend and finally feeling like I fit in.
However, by the end of that time, the loop was back, louder than ever. I didn’t feel like I fit in anymore and realized I was being used because I was the one who always had money and a car.
Addicts and alcoholics often try to stop this disease on our own — drinking beer instead of liquor, using weed instead of cocaine, only using on weekends, etc. Another common tactic is the “geographic cure.” At the end of my teenage drug phase, I opted for that one. I suddenly decided to attend a small private hippie high school in the wilds of British Columbia, Canada. I told my parents I was going and since I had the money saved up from farm work and other jobs, I went. And it worked — at least for the alcohol and drugs.
It wasn’t until much later that I figured out I was really trying to flee the self-demeaning brain loop.
Drugs and alcohol didn’t play a significant part in my life again until my early 40s. If you looked at my life from the outside at that time, you’d wonder why anyone in that situation would start using drugs.
I was the medical director of the ER, well respected by my colleagues and patients. My wife, also a doctor and I had two wonderful daughters, had paid off our medical school loans and owned our home outright.
But what you wouldn’t see was that toxic brain loop that never quit playing. That loop, combined with the stress of working in the ER day after day, left me subconsciously searching for a pressure relief valve.
That valve appeared in the form of a drug called Ultram (a combination of Tramadol and Tylenol), which hit the market in the late ’90s as a new non addictive pain reliever. The drug company’s reps would deliver grocery bags full of samples to the ER, encouraging us to hand them out to patients. I don’t remember exactly when I tried it for some ache or pain, but I do remember thinking it didn’t do much for pain. However, it did make my 12-hour ER shifts easier. It was quieting “the loop,” giving me a weird distance from the intensity of patients and a sense of calm amidst the ER storm. Later, researchers discovered tramadol has opiate-like and antidepressant-like effects, is highly addicting and is now classified as a narcotic.
Thus, I was inadvertently taking a narcotic and thinking I had everything under control.
Within a few months, I was taking three or four tablets at a time throughout the day, drinking tons of caffeine (standard ER fare) and adding a muscle relaxant to keep me from feeling too wired. When I got home, I drank wine and took Benadryl to sleep. This cycle continued for almost four years. My wife repeatedly asked if I was using drugs, but I always lied and would often turn the tables, acting hurt or angry that she would even ask.
Fortunately for me, the drugs I was using, combined with chronic sleep deprivation from constantly switching day and night shifts, resulted in me having a seizure in front of my wife, my daughters and my parents at a restaurant in Montreal in 2003. That night, frightened by what had just happened, I finally admitted to myself that I was in trouble, that my life was out of control. The next morning, I told my wife the truth.
What followed was truly miraculous. She didn’t leave me and take the kids. She helped me get in contact with and begin treatment through The Committee for Physician Health (CPH), an organization that helps doctors with substance use problems. I was mandated to go to AA meetings, which I initially resisted, then realized was a gift that’s turned into a lifetime “habit.” I told the CEO of the hospital, the medical staff director, and my ER colleagues what I was dealing with, and every one of them responded with encouragement and support. I felt like I’d been released from prison; my life was no longer controlled by drugs.
The rest is history. I left emergency medicine five years into my recovery. A friend told me he was leaving a part-time job at the JL Norris Clinic (inpatient rehab), which I took. There, I met Dr. Charlie Morgan, the rehab medical director, who became my teacher and mentor. That led to me getting board-certified in addiction medicine. And now I’m semi-retired with my own solo, part-time addiction medicine practice after 15 years as the clinical director and then medical director of Rochester Regional Health’s chemical dependency programs.
More importantly, I’ve regained the trust and love of my family. My two daughters, now grown, have loved me through every step of my recovery. My wife has never deviated from my side, treating me with love, care, and compassion that I’ll never be able to fully repay. I’ve learned to accept help from others.
And that brain loop?
It still plays occasionally, but not continuously. And I no longer believe its toxic message, nor do I have to try to silence it with drugs or alcohol.
10 Tips If You Think You Have A Substance Use Disorder
By Mark Winsberg, M.D.
1. Acknowledge the Problem
The first step in recovery is admitting that there is a problem. Denial can be a significant barrier, and recognizing the impact of substance use on health, relationships and daily life is crucial.
2. Seek Professional Help
Addiction medicine specialists, therapists, and counselors can provide evidence-based treatments, including medication-assisted therapy (MAT) and behavioral therapies like cognitive-behavioral therapy (CBT) or motivational interviewing (MI).
3. Develop a Strong Support System
Surrounding oneself with supportive friends, family or support groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) can provide encouragement, accountability and emotional support.
4. Identify and Avoid Triggers
Recognizing situations, places or people that contribute to substance use can help in developing strategies to avoid or manage them. Creating a structured and substance-free environment is essential.
5. Adopt Healthy Coping Mechanisms
Replacing substance use with positive activities such as exercise, meditation, yoga or creative outlets (e.g., music, art, writing) can reduce stress and cravings.
6. Establish a Routine and Set Goals
Having a daily routine with scheduled activities helps reduce idle time and provides structure. Setting realistic, short-term goals can provide a sense of accomplishment and motivation.
7. Address Underlying Mental Health Issues
Many people struggling with addiction also have co-occurring mental health conditions like depression, anxiety or PTSD. Seeking treatment for these conditions through therapy or medication can improve overall well-being.
8. Consider Medication- Assisted Treatment (MAT)
For some substance use disorders (e.g., opioid or alcohol addiction), medications like methadone, buprenorphine or naltrexone can help reduce cravings and withdrawal symptoms under medical supervision.
9. Educate Yourself About Addiction
Understanding addiction as a chronic disease rather than a moral failing can help reduce guilt and self-stigma, making it easier to seek treatment and stay committed to recovery.
10. Practice Self-Compassion and Patience
Recovery is a journey with ups and downs. Being kind to oneself, acknowledging progress and learning from relapses instead of seeing them as failures can improve long-term success.
Physician Mark Winsberg is the former medical director of Rochester Regional Health chemical dependency department. He now operates Medical Services, PLLC in Rochester. Contact him at drmark@winsbergmd.com or via text message at 585-565-5220. For more information, visit www.winsbergmd.com.