I'm not going to lecture you,

You asked for opinions.... So... my personal opinion is if the alcohol is something you can tell is causing you problem then by all means you need to stop.

Marijuana... I don't think that it's an oh so terrible thing, maybe it's just as bad as medications? I don't know. I know it's used for chronic pain and during cancer treatments and many other illnesses.

Work on a plan of stopping whatever you feel you need to with your Pdoc/T.

Anyway just my opinion.

Good Luck