Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- Who provides it
- An addiction medicine doctor (narcologist) and a psychotherapist; family sessions involve relatives
- Where
- At the clinic, by video, or at home during a mobile team visit
- Duration
- One session lasts 50–60 minutes; usually 1–4 sessions before a decision to start treatment
- Anonymity
- No surnames and no registry; the conversation stays between the doctor and the family
- When it’s urgent
- Psychosis, seizures, overdose, threats to self or others — call 103 or 112
- Outcome
- Voluntary agreement to an examination, detox or a course of treatment
What you should know
On home visits, I often see the same scene. All the relatives have gathered in an apartment in Alatau district, there are pills and clinic brochures on the table, and the man on the couch keeps saying one thing: “I’m not an alcoholic, I’ll quit on my own.” The harder they push, the tighter he clings to that phrase. Over the years, I’ve learned that shouting someone into treatment doesn’t work, while a properly structured conversation works far more often than a desperate family might think.
My job on a call like this is first to relieve any acute condition and then to talk with the person one-on-one, without an audience. I don’t argue about the word “alcoholism.” I ask what is getting in the way of his life, how he is sleeping, what his cardiologist says, what will happen with his job. When the person says out loud that things can’t go on like this, that is where motivation begins. After that, it is important not to miss the moment and to offer a concrete, clear and achievable step right away.
When You Need Help Motivating Someone to Accept Treatment
- the person denies there is a problem even though binges or drug use keep recurring
- promises to quit come after every relapse but are never kept
- conversations about treatment end in resentment, aggression or the person walking out
- agreement to treatment appears only during a hangover and disappears a day later
- the person is afraid of being put on a registry, of exposure, or of losing their job or driver’s license
- previous treatment didn’t help, and they are convinced that “nothing works”
- the family has tried persuasion, threats and ultimatums with no result
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 People with Addiction Refuse Treatment
Denial is not stubbornness but part of the illness. Over time, the substance becomes the main way of coping with stress, boredom and anxiety, and the thought of life without it is frightening. In addition, a person with an addiction often has reduced insight into their own condition. They sincerely compare themselves with people who “drink worse” and see no problem. In this situation, pressure usually triggers defensiveness and even deeper denial.
There are also very practical fears: of being put on a registry, of people at work finding out, of having to stay in hospital, of pain and shame. Many remember severe withdrawal and are afraid of going through it again. When these fears are voiced and get honest answers — anonymity, detox under medical supervision, the option of outpatient treatment — resistance often decreases.
How Motivation Work Unfolds: From the First Session to Agreement
It usually starts with a consultation for relatives: the doctor gathers the history, assesses the risks and, together with the family, chooses the moment and form of the conversation. Then, if the person agrees to at least a talk, a session is held with them, in person or by video. If a binge is underway, the team comes to the home — whether in Bostandyk district or in Talgar — relieves the acute intoxication and holds the motivational conversation once the person’s mind is clearer. It ends with a concrete next step and a date.
A motivational conversation is not held with someone who is heavily intoxicated or has psychosis, delirium, seizures or signs of overdose — safety comes first, and if there is a threat to life, call 103 or 112. You must not bring a person to the clinic by deception: trust will be lost, and treatment without consent is possible only by court decision. If the person expresses thoughts of suicide, they need urgent help from a psychiatrist.
How we help
Motivational interviewing
This is an evidence-based conversational method recommended by international guidelines for working with addiction. The doctor doesn’t argue or impose a diagnosis but helps the person see the gap between their values and where their substance use is leading. Through open questions and reflecting back what they hear, the person puts the reasons for change into words themselves — which means the decision becomes truly their own.
Family reinforcement methods
Relatives are taught to reward sober behavior and to stop softening the consequences of substance use. For example, not calling the boss with excuses and not handing over money, but spending time together when the person is sober. According to research, programs like this lead people with addiction to treatment more often than confrontational “interventions” with ultimatums.
A prepared conversation
Together with the doctor, the family chooses the right moment — a sober morning, not the night after a fight — as well as who will take part and what to say. They talk about specific events and their own feelings, without labels or threats, and immediately offer a real form of help: a consultation, a doctor’s visit, an anonymous inpatient stay. Having a ready plan lowers the risk that the conversation will turn into another argument.
Easing fears about treatment
Many people are held back by the unknown. The Narcology 24 doctor explains in detail how detox works, how long it lasts, whether it will hurt, what anonymity means and why there is no registry. Sometimes it helps simply to show the room or arrange a trial video consultation. The clearer the first step, the easier it is for the person to take it.
Myths and facts
MythA person with an addiction has to “hit rock bottom” before they’ll get treatment
FactWaiting for “rock bottom” is dangerous: it can mean an injury, a serious illness or death. Motivation can be built earlier, and treatment started for external reasons can be effective too.
MythThe best approach is a tough ultimatum from the whole family
FactConfrontation often deepens denial and destroys trust. Consistent boundaries and a calm conversation with a concrete offer of help work much better than shouting, threats and family “trials.”
MythIf the person agreed while hungover, the job is done
FactAgreement during withdrawal can be sincere but unstable. It is important to act right away: book an appointment, call the doctor, agree on a date. A postponed decision often disappears along with the hangover.
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 Almaty
| Online addiction doctor consultation | 10 000 ₸ |
| In-person addiction doctor consultation | 12 000 ₸ |
| Family consultation | 12 000 ₸ |
| 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
Narcology 24 in Almaty: our duty team makes home visits day and night, usually within an hour (all city districts and nearby settlements). Two branches for appointments and procedures — 84 Zhandosova St., Almaty and 21 Seyfullina Ave., office 11, Almaty. When indicated, we arrange admission and transport.
Confidential and private
Information about your request, diagnosis and treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. We do not share it with employers, schools, the police or neighbours; the only exceptions are those expressly set by law. A first name is enough to call us, and paid confidential treatment does not mean a registry entry.
Questions and answers
How do I start a conversation about treatment with my husband or son?
Choose a moment when the person is sober and calm. Talk about specific incidents and your own feelings, not about their character. Offer one real step: a consultation or a video call with a doctor. Before the conversation, it helps to consult an addiction doctor to think through your words and the possible responses.
What if he denies everything?
Don’t argue about the diagnosis. It is enough to agree on a small step: a health check, some lab tests, a talk with a doctor about sleep or blood pressure. Often it is a conversation about health, rather than about “drinking,” that opens the way to treatment. Denial weakens gradually.
Can a doctor come over and convince him?
A doctor can come out on a call, for example during a binge, and after relieving the acute condition talk with the person in private. This often helps because the conversation is led by a specialist rather than a relative. But no one can be convinced by force: the decision remains with the patient.
Can someone be sent for treatment without their consent?
Admission to the clinic is voluntary only. Involuntary treatment in Kazakhstan is possible only by court decision under the procedure established by law, and it is a complicated process. Doctors recommend trying motivational approaches first: they more often produce a lasting result.
How long does motivation take?
It varies: sometimes one session is enough, sometimes it takes weeks. The pace depends on the severity of the addiction, family relationships and past experience of treatment. Regular sessions with a psychotherapist and consistency from relatives usually speed up the decision. The video format helps avoid missing sessions because of traffic.
What if he agreed but then changed his mind?
This happens a lot. Don’t blame him and don’t abandon the plan. Calmly remind him of what you agreed on and suggest coming back to the conversation. Stay in touch with the doctor: they will help you understand what has changed and choose a moment when the person is ready again.
Where do doctors visit in Almaty and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 84 Zhandosova St., Almaty and 21 Seyfullina Ave., office 11, Almaty. Phone in Almaty: +7 (700) 309-29-88.
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
