Challenging social drinking norms

It can be an uncomfortable conversation, but grey area drinking coach Sarah Rusbatch is encouraging doctors to raise alcohol use with their patients.


Doctors play a crucial role in promoting overall health and wellbeing and part of this responsibility includes addressing issues related to alcohol. However, a reluctance to probe and the acceptance of social drinking can sometimes hinder an open and honest discussion with patients.

Sarah Rusbatch

The reluctance of doctors to delve into their patients’ drinking habits can be attributed to a range of factors. One key factor is the fear of judgment and potential strain on the doctor-patient relationship. Doctors may be concerned that raising issues around alcohol consumption may alienate patients and lead to them avoiding medical care altogether. It is a delicate balance that doctors must strike, and it requires effective, compassionate communication.

There is also a societal norm that accepts social drinking as an ordinary and even ‘healthy’ practice in moderation. However, moderate drinking can, and does, easily tip into excessive or problematic drinking. 

There is a fine line between responsible alcohol use and potential problem drinking, and patients may need help to understand these boundaries. The World Health Organisation now recognises there is no safe amount of alcohol. 

How can doctors navigate these challenges? 

Empathy. Patients should feel comfortable discussing their drinking habits without fearing judgment. Physicians can create this environment by showing empathy and understanding and framing the conversation as part of their overall health assessment.

Understand the risks. It’s vital for doctors to be well-informed about the risks associated with all levels of drinking. Armed with the latest research, they can provide patients with accurate information about the potential health implications of their drinking habits. This knowledge can empower patients to make informed decisions about their alcohol use, or to abstain entirely.

Normalise sobriety

Doctors can play a key role in normalising sobriety. Encouraging patients to reflect on their drinking habits and arm them with sober support networks is vital. It’s essential for patients to understand that there is a spectrum of drinking behaviours, and the goal can be abstinence without stigma or judgment.

Tipping points

Patients need to be aware of the dangers of ‘social drinking’ that can spiral into problematic use and the subsequent potential negative impact on their health, their relationships, and their life. It’s important to counter the myth that drinking is a rite of passage and that excessive alcohol use is a ‘lifestyle’. More than eight glasses of wine a week is considered alcohol use disorder. 

Sober networks

This may involve referring patients to addiction specialists, therapists or support groups. Having a network of professionals who can guide patients through the process of change without judgment is important.

Doctors play a vital role in addressing the subject of alcohol with their patients, even in the face of reluctance and societal norms. The key to success lies in open and non-judgmental communication, accurate information and a nuanced understanding of the spectrum of drinking behaviours.

By encouraging an open dialogue and providing the necessary resources, doctors can help their patients develop a healthier relationship with alcohol. It’s a challenge that, when met with empathy, will lead to better patient outcomes. 

ED: Sarah Rusbatch is one of Australia’s first accredited grey area drinking coaches and a public speaker and author.