The risk was far less terrible than, say, a few dozen tactical nukes used by one of the sides in a third war across Europe, as the status quo of warsaw pact borders wasn't that acceptable to both armies, and only MAD ensured that the cold war didn't become hot.
MAD was the only possible strategy. However, the insane level of weaponry that was actually in place was, in my view, completely unnecessary. If your opponent is deterred by one level of force then having a hundred times this level does not make you safer.
[NB In case anyone interprets my position as somehow being in support of the Soviets - they were, as far as I am concerned, a criminal regime just as "evil" in their own ways as the other nightmares of the 20th century. However, the level of strategic threat they posed was wildly overstated for political ends.]
They certainly did contemplate that as valid military options - they had even placed nuclear "mines" (underground room-sized nukes) in [less] populated friendly areas, planning to detonate them below enemy divisions if/when they are forced to retreat. So even nuking your own civilians was considered as an acceptable cost in case of a hot war.
One UK political leader has had the courage to admit that even if the UK had received a nuclear attack from the Soviets he would not have launched a retaliatory strike. After all, if your deterrent fails - what exactly is the point in using it? [Not something you can admit at the time, of course.]
Would a West German political leader really have agreed to nuclear land mines being used? Most of the weaponry in the Cold War was there for posturing - no political leader ever expected to use them. Even Khrushchev (who was clearly a hard bastard) could only cope with the thought of nuclear weapons by accepting the fact that they would never actually be used - it was all a bluff.
For a truly insane value of "worked" - running terrible (and largely unnecessary) levels of risk for decades hardly has much to recommend it.