'I'm 44 and drink a bottle of wine a night. I can't even fathom how I'd quit.'

Dear Doctor,

I’m a mid-life woman who has always enjoyed a drink with friends. However, in recent years these drinks with friends have turned into a daily drink every evening at home. A little treat after a hard day at work, or with the kids at home. Or to celebrate a win or goal achieved. I’m now drinking daily, sometimes a bottle of wine each night. I’m waking feeling tired, foggy and anxious most mornings which leads to determination not to drink that night. But come 5pm, I find myself reaching for the wine, telling myself I’m just going to have the one glass. I’d love to quit drinking completely, but can’t even fathom how I would do this, especially with all the social pressure in our culture.

Everyone says the first step is to talk to your GP, but I really have no idea what supports are available.

Kylie, 44.

***

Dear Kylie,

You have such great insight into your own habits and behaviour, as well as into the Australian drinking culture. Growing up in the 1990s and 2000s, binge drinking was how most of us spent our weekends with family and friends. I have many memories fuelled by Strongbow Whites and tequila shots, dancing the night away and then curing our hangovers the next day with a greasy meal. All I can say is thank goodness there were no smartphones in those days!

But as we’ve all got older it’s been difficult for many of us to transition into healthy drinking habits due to this shared background where alcohol was the central focus for any occasion. For many of us in this generation, our drinking habits have become problematic and damaging to our physical and mental health, as well as to our relationships and our financial security.

The first step is always for the patient to admit to themselves that their habit has become a problem. It is absolutely not easy to get to this step, so I really do applaud you for being so honest with yourself and reaching out for help. And, your GP is definitely the right place to start in seeking support for this complex issue.

My first step to support patients with concerns around alcohol is to assess their level of dependence. This is through asking questions such as how many drinks are you having each day, do you ever have alcohol-free days, do you ever have cravings for alcohol and if you have any withdrawal symptoms such as sweating, tremors, nausea and agitation. This will help determine if we need an inpatient admission to assist with alcohol cessation (which your GP will organise for you) or whether we can support you in the community.

If we can safely support you in the community, we will first send you for some blood tests and provide you with information about medications that can assist you with maintaining abstinence from alcohol. There are a few different medications that can assist, and we will choose the right one for you based on your previous drinking habits as well as any other health issues you may have. But in general, these medications remove any pleasurable effects of alcohol and in fact, some can cause you to feel negative physical effects when drinking. In my experience, prescribing the right medication is integral to the successful cessation of alcohol and the ongoing maintenance of abstinence.

Watch: Here are just some of the effects after one year without drinking alcohol. Post continues after video.

We will also set you up with a mental health care plan, as psychology support and counselling is an integral part of the process. As an alternative to this, there may be a local Alcohol and Drug service that your GP can refer you to for holistic support in the community, and there are now telehealth services available so that even patients in rural and remote areas can access support, for example, Clean Slate Clinic.

A counsellor or psychologist can be vital in workshopping strategies to have difficult conversations with friends and family, as well as to help develop healthy coping strategies to replace the role alcohol may have played in this regard. There may also be group therapy sessions available in your local community that your GP can recommend, for example, Alcoholics Anonymous.

I usually offer to have a consult with the patient and any close family members who will be also providing support during the alcohol cessation process. This is so we can answer any questions they have and ensure they understand how to assist with medication and manage any withdrawal effects.

While you are waiting to see your GP, there are some fantastic online communities and resources available to help you. Hello Sunday Morning and Sober in the Country are resources that I often recommend for patients wanting to explore sobriety further.

Phew. Ok. Pretty heavy stuff, I know. It’s not a light topic at all, and for sure there will be ups and downs in this process. As always, your GP is there to be your cheerleader as well as to listen to any concerns you have. I ensure my patients know the door is always open and there is zero judgment should we not be successful in abstinence on the first attempt. We are there for the journey every step of the way.

While you're here, listen to MID where Shanna Whan from Sober In The Country about why Generation X women drink so damn much. Post continues below.

Dr Rebecca Goadby is a General Practitioner who is passionate about the health of women through every stage of their lives. Her approach is compassionate and holistic, with a focus on preventative medicine and mental health wellbeing.

Information found in this column is not meant to be a substitute for proper medical advice – please contact your doctor or a health professional to discuss your own medical needs.

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Feature image: Getty.