It took a long time for Shanna Whan to realise there was a problem.
For years, she repeated a mantra to tell herself her relationship with alcohol was OK.
"It's fine; I'm not an alcoholic, I'm an Australian," she remembers thinking.
Now, she feels differently.
"[I'd been raised with] all of those recycled, terribly overused things that make alcohol addiction seem normal rather than horrific,' she said.
"So, I truly never thought I was someone addicted to alcohol because I worked and I was successful."
Shanna lives in north-west New South Wales and the remote location made socialising even more important for human connection.
But often, that would be centred around events that encouraged heavy drinking.
Her drinking helped her to cope with untreated trauma from multiple sexual assaults at the age of 18, during her 'gap year' working on pastoral stations and she says it was also a way for her to deal with social anxiety.
But she soon became dependent, and later, addicted
"In the blink of an eye, you're almost 40," she said.
"And those couple of drinks at parties have turned into a six pack, have turned into sitting up till 5am and watching sunrise being the drunkest on ground with the boys. And before you know it, you're the person taking your alcohol use to the privacy of your own home."
There, she drank heavily. But eight years ago, she awoke in hospital after a drunken fall and realised her choice was to change or die.
"I was a suicidal, sick, desperately-close-to-death human. It was horrific," Ms Whan said.
The shock of her situation acted as motivation and, through hard work and with the support of her husband Tim, she stopped drinking.
She later founded the not-for-profit, Sober In The Country, which has now blossomed into a social impact enterprise and peer support network called the Bush Tribe.
"It takes on average 18 years for someone to seek help. So there's like nearly two decades that people are falling and we don't even see it," she said.
Providing support in the bush
"Alcohol is one of the most dangerous drugs to detox from," said Chris Davis, a general practitioner who specialises in drug and alcohol services.
"Going cold turkey, if you're alcohol dependent, can lead to seizures and death."
Dr Davis is one of the operators of an in-home detox service called Clean Slate Clinic.
He provided a similar service in the UK before launching it in Australia to counter a lack of detox services in western Sydney.
Since the onset of COVID, the program has moved to a 100 per cent virtual format where patients are assessed for their suitability and then receive a medicated detox plan including pharmaceuticals and vitamins, equipment like a breathalyser, and blood pressure monitor.
They are also provided with daily telehealth sessions which are followed by rehabilitation support and periodic check-ins.
"Going through an alcohol withdrawal process in your own environment, where you have to learn to live with those stresses of everyday life, is really powerful," Dr Davis said.
"Plus, it means that your support network, your family and friends, they go on that journey with you. So, they get support and they get education around what to do if someone relapses."
The stigma of quitting drinking
Now, the program is being trialled in country New South Wales and outback Queensland to see if it can be adapted to the needs of remote patients.
While the service can include detox from a range of substances, clinicians say the main area of detox needed in rural areas is alcohol.
However, access to medicated detox services is limited for people in the regions, meaning many need to leave their communities to travel long distances, at great expense, to seek treatment in larger centres.
That alone can act as a deterrent to seeking help.
"We've had our first few people sign up in regional Queensland and New South Wales," said Clean Slate Clinic co-founder Chris Raine.
"It's the type of model that fits in perfectly for regional and remote Australia which is why we really want to invest in the relationships to make it a success out here."
The trial will also be used to tailor the program according to the unique needs of people in more rural and remote settings. But Mr Raine said the anonymity offered through the program would particularly appeal to those in small towns.
"Quitting drinking can be highly stigmatised," he said. "But with this, nobody needs to know that you're doing it.
"You can stay on (your) property or in an environment where you can keep working if it's suitable. It's not as disruptive as detoxes can be."
The service is designed to work in collaboration with existing services, like those offered by alcohol and other drugs (AOD) counsellor Nicky Wildermuth. She works for AOD organisation Lives Lived Well in the outback Queensland town of Longreach.
She said while demand for services like hers had remained steady, there had been a noticeable rise in the number of people self-referring to get help, signalling a potential cultural shift.
"They're [making] that call themselves and asking for that treatment and support, which I think is a real positive."
Meeting the needs of First Nations people
Sandy Gillies is the chief executive officer of the Western Queensland Primary Health Network (PHN), which commissioned one of the trials.
She said the region had one of the highest rates of risky alcohol consumption in the state but lacked services, and could not afford to build a facility or recruit the workers needed to run it.
"The statistics are telling us there's a need and here's an opportunity for us to do something that's positive," she said.
She was born in the outback and is also the first Indigenous person to head up one of the 31 PHNs across the nation.
A lot of her work focuses on First Nations health which is also an area in which Clean Slate is looking to provide culturally safe services.
"We want to explore the cultural responsiveness and safety of a service such as this, especially in our rural and remote Aboriginal and Torres Strait Islander communities," Ms Gillies said.
"With any program you're trying to deliver to First Nations populations, it needs to take in those cultural considerations but also the cultural strengths. It's critical that we actually embark on designing [it] to meet the needs of our First Nations populations."
But she's optimistic this ticks the right boxes for the whole community.
"When you live out here in these regions, you just know you're on a winner."
The program is funded to run until the end of June next year when it will be assessed for its efficacy and, depending on the results, is a format that could be rolled out to other rural and remote areas.
A beacon of hope
Back in country NSW, Shanna Whan thinks the style of service will appeal to many people in the bush, but also said it was important to realise it would not suit everyone.
"If it is given to people at a good time in the escalation of their addiction, it's a game changer," she said.
But already, one of her Bush Tribe members has secured a home detox place.
"That little beacon of hope and help for that person - who very much lives very remotely — to know they can have a GP and a nurse and a program to follow in their remote locations … I think it's a powerful opportunity."
