Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F11.2
- Who provides it
- A psychiatrist-narcologist at the clinic, after detox and an assessment
- Where
- At the clinic in Aksay or in the inpatient unit where the patient went through detox
- Duration
- The procedure takes 30–60 minutes; how long it works depends on the dosage form
- Confidentiality
- Anonymous, with no registration in the state narcology registry; information is protected by medical confidentiality
- When it is an emergency
- Slow breathing, blue lips or loss of consciousness after using — call 103 or 112
- Outcome
- The effect of opioids is blocked and remission is supported during treatment
What you should know
Opioid dependence (F11.2 in ICD-10) is a chronic disease with a high risk of relapse and overdose. Opioid receptor antagonists occupy the same receptors as heroin, methadone, morphine and other opioids, but do not activate them. While the drug is working, opioids do not produce their usual effect, so using them becomes pointless. The WHO and international guidelines consider antagonists one of the options for supporting remission in motivated patients after detox.
An opioid blockade in Aksay at Narcology 24 is carried out by a psychiatrist-narcologist. The key safety condition is that there are no opioids in the body: if an antagonist is given while opioids are still present, severe withdrawal develops. That is why the procedure is preceded by detox, the required period of abstinence, testing and, if there is any doubt, a challenge test. The patient receives full information about how the drug works, how long it lasts and its risks, and signs an informed consent form.
Who an opioid receptor blockade is for
- people with opioid dependence who have completed detox and decided to stop using
- those who still have strong cravings and a high risk of relapse after detox
- patients for whom a medication “safety net” matters in the first months of remission
- those who are in rehab or outpatient psychotherapy
- people who have completed the required abstinence period and test negative for opioids
- people without severe liver damage or acute hepatitis
- people who do not need pain relief with opioid medications
If two or three points apply, it is worth seeing a doctor. Phone advice is free and confidential. If life is at risk, call 103 or 112.
Why remission needs support after detox
Opioids change how the brain's reward system works, and after detox cravings often persist for months. Stress, meeting old acquaintances, insomnia and depression can easily trigger a relapse. Without support, most people go back to using within the first weeks and months after detox — this is recognized by international clinical guidelines.
The most dangerous moment of a relapse is the first use after a break: tolerance is lower, and a dose that used to be “normal” can suppress breathing. The antagonist lowers this risk while it is working, but once it wears off, tolerance also remains low. That is why the patient is always told about the risk of overdose, and the family is advised to learn the signs of depressed breathing and to call 103 or 112 immediately.
How an opioid blockade works: preparation and procedure
Stage 1 — a consultation, which can start online: history of use, previous treatment attempts, illnesses and motivation. Stage 2 — detox at home or in an inpatient unit. Stage 3 — a period of abstinence, the length of which the doctor sets depending on the substance. Stage 4 — lab tests, an opioid test and, if necessary, a challenge test. Stage 5 — informed consent and administration of the drug. Stage 6 — regular follow-up and psychotherapy.
A blockade is not carried out if there are opioids in the body, a positive test, signs of withdrawal, acute hepatitis or liver failure, a need for opioid pain relief, an allergy to the drug, or pregnancy without a separate decision by the doctor. Trying to “override” the blockade with large doses of opioids is potentially fatal — if breathing becomes depressed, call 103 or 112.
How we help
Preparation and detox
Before the blockade, withdrawal must be fully completed and the abstinence period observed: it is shorter for short-acting opioids and longer for long-acting substances. Detox is carried out in an inpatient unit or as an outpatient with doctor home visits. This is a mandatory condition: giving an antagonist while opioids are present causes severe withdrawal.
Checking readiness
The doctor assesses how the patient feels and confirms there are no signs of withdrawal, then carries out a rapid urine test for opioids. If doubts remain, a challenge test with a small amount of a short-acting antagonist may be done under observation. Liver function is also assessed, since the drugs are metabolized there.
Administering the antagonist
Opioid receptor antagonists are available as daily tablets, long-acting injections or implants. The choice depends on the patient's preferences and the need to monitor adherence. Only the doctor decides on the form, dose and route of administration. After the procedure, the patient stays under observation to rule out unwanted reactions.
Comprehensive support
A blockade lowers the risk of relapse but does not teach a person how to live without the substance. That is why Narcology 24 combines it with psychotherapy, rehab programs, family counseling and treatment of co-occurring depression and anxiety. Regular visits to the addiction physician help track the patient's condition and extend or change treatment in good time.
Myths and facts
MythA blockade makes a person immune to any dose
FactAn antagonist can be “overridden” by large doses of opioids, and this is potentially fatal because of depressed breathing. A blockade protects only if the person stops using; it does not make using safe.
MythA blockade can be given right after the last dose
FactGiving an antagonist while opioids are present causes severe and extremely distressing withdrawal. That is why detox, a period of abstinence and confirmation that there are no opioids in the body are needed first.
MythNo further treatment is needed after a blockade
FactThe drug only blocks the effect of opioids. The causes of dependence — cravings, stress, social environment and co-occurring disorders — require psychotherapy and rehab. Without them, the risk of relapse returns once the drug wears off.
How a home visit works
- Call or message usThe dispatcher answers 24/7 and in 3–5 minutes checks the person's condition, age, how long the drinking or use has lasted, chronic conditions and the address. No surname needed.
- The doctor sets offAn addiction doctor or psychiatrist comes with equipment and medication. Travel time depends on the district — usually within an hour. If inpatient care or an ambulance is needed, we'll say so straight away.
- Examination and treatmentBlood pressure, pulse, oxygen saturation, blood sugar if needed and a neurological check. Then an IV drip or other treatment as indicated, 1–3 hours.
- A plan for the next daysAdvice for the family on what to do overnight and tomorrow, phone follow-up and a repeat visit if needed.
- Further treatmentCoding, psychotherapy, rehab or psychiatric follow-up — once the acute state has passed and the person is ready.
Prices in Aksay
| Consultation and assessment before the procedure | 8 000 ₸ |
| Procedure (standard) | 40 000 ₸ |
| Procedure (extended) | 64 000 ₸ |
| Phone advice | free |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
In aksay you can get help at home, at one of our two branches (7 Stroitelnaya St., office 14, Aksay, 154 Molodezhnaya St., Aksay) or online if you need a consultation rather than a procedure. The dispatcher answers 24/7 and will tell you straight away which option is safest.
Confidential and private
in Aksay our doctor can come in ordinary clothes in an unmarked car. Treatment documents are given only to the patient. If you need a certificate or sick note, this is discussed separately and only at your request.
Questions and answers
How long do you need to abstain before a blockade?
The period depends on the substance: for short-acting opioids it is usually shorter, and for methadone and other long-acting substances it is considerably longer. The addiction physician sets the exact period after a consultation. A test confirming the absence of opioids is always done before the procedure.
How long does the blockade last?
Tablets work for about a day and must be taken daily. Long-acting injections and implants remain effective for weeks or months, depending on the drug. The doctor chooses the option that fits the patient's lifestyle and preferences.
What happens if you use opioids during the blockade?
There will be no usual effect. Trying to overcome the blockade with a large dose can lead to depressed breathing and death. If the person is unconscious, breathing slowly or their lips are turning blue, call 103 or 112 immediately and tell them about the blockade.
Can I take painkillers during the blockade?
Opioid painkillers do not work while the antagonist is active. The patient is advised to carry information about the blockade and to tell any doctor about it, especially before surgery. Pain relief is provided with medications from other groups.
Does a blockade help with alcohol dependence?
Opioid receptor antagonists are also used for alcohol dependence: they reduce cravings and the rewarding effect of alcohol. However, the goals, preparation and treatment regimen differ, so the decision is made after a consultation with an addiction physician.
Is treatment confidential?
Yes. At Narcology 24, treatment for opioid dependence is anonymous and does not involve registration with the state narcology registry. Information is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System” and is disclosed only in cases provided for by law.
Where do doctors visit in Aksay and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 7 Stroitelnaya St., office 14, Aksay and 154 Molodezhnaya St., Aksay. Phone in Aksay: +7 (700) 309-30-65.
Sources and methodology
This page was prepared by the Narcology 24 medical editorial team based on:
- International Classification of Diseases ICD-10 and ICD-11, World Health Organization
- Clinical diagnosis and treatment protocols of the Ministry of Health of the Republic of Kazakhstan
- Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
- NICE (UK) guidelines on alcohol and drug misuse and mental health conditions
- WHO recommendations on the treatment of substance use disorders
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
