Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F11.2
- Who provides care
- A psychiatrist-addiction specialist (narcologist) at the clinic
- Where
- The clinic’s treatment room in Almaty, after detox
- Duration
- The procedure with observation takes up to an hour; the duration of effect depends on the form of the medication
- Anonymity
- No registry, medical confidentiality, under a name of your choice
- When it is urgent
- Signs of overdose, slow breathing, loss of consciousness — call 103 or 112
- Outcome
- Protection against relapse while it is in effect, and time for rehab
What you should know
We do not usually get to the conversation about a blockade on the first day we meet. First comes a night call from relatives and a house call to an apartment, say in the Alatau district, where the person has been without the substance for three days and is “twisting” with withdrawal. Then several days of withdrawal treatment, more often in an inpatient unit. And only when the acute symptoms are behind them does the main question arise: how do they stay clean from here on? This is where a blockade can become one source of support — but only one.
I always warn people about the most important thing: a blockade is given only when there are no opioids left in the body. If an antagonist is given too early, it will cause sudden, severe withdrawal. That is why the procedure is preceded by a sufficient period of abstinence, a test and, if necessary, a challenge test under a doctor’s supervision. The person comes to the clinic alone or with loved ones, from the Medeu district or from Talgar, and we do not rush until we are sure everything is safe.
Who an Opioid Blockade May Be Right For
- the person has completed detox and wants to consolidate quitting opioids
- after previous attempts, relapses happened in the first few weeks
- a lab test and a rapid test confirm there are no opioids in the body
- the examination shows no serious liver damage
- the person is ready for psychotherapy, rehab or support groups
- protection is needed while returning to work, studies and family life
- loved ones understand that a blockade is part of treatment, not a “vaccine”
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.
How an Opioid Blockade Works and Why Preparation Matters
Opioid receptor antagonists occupy the same receptors in the nervous system that opioids act on, but they do not activate them. While the medication is working, using opioids does not produce the usual effect, and the link between “substance” and “relief” gradually weakens. WHO and international guidelines consider this therapy one of the options for support after detox, together with psychosocial help.
There are two serious risks that the doctor is obliged to warn you about. First, giving an antagonist while opioids are still present causes severe, immediate withdrawal, which is why an abstinence period and tests are needed. Second, trying to “break through” the blockade with a large dose, or using after the blockade has worn off, when tolerance is reduced, can lead to a fatal overdose. We say this directly to both the patient and the family.
How an Opioid Blockade Is Given: Stages and Checks
The first consultation can be held by video: the doctor learns about the history of use, previous treatment attempts, illnesses and readiness for the procedure, and relatives can ask their questions. Then comes an in-person appointment after detox: an examination, blood tests (especially liver function), an opioid test and, if necessary, a challenge test. A written informed consent form is signed. The medication is given as an intramuscular injection or as an implant, followed by observation and a schedule of sessions with a psychotherapist.
A blockade is not given with a positive opioid test or an insufficient period of abstinence, serious liver damage, acute hepatitis, a number of mental disorders, pregnancy, a need for opioid painkillers, an allergy to the medication, or without the person’s consent. If there are signs of an overdose — pinpoint pupils, slow breathing, bluish skin, loss of consciousness — call 103 or 112 immediately.
How we help
Preparation stage
Before a blockade, detox and a period of abstinence are mandatory; its length depends on the substance and is determined by the doctor. An opioid test is done and liver function is assessed. If there are any doubts, the doctor may carry out a challenge test with a short-acting antagonist under observation: if there is no reaction, the long-acting form can be given. These steps must not be skipped.
Long-acting injection
The long-acting form is injected into a muscle and keeps the receptors blocked for a set period, after which the injection can be repeated. The advantage of this option is that there is no need to take pills every day, and the person cannot “skip” a dose at a difficult moment. The duration and frequency are discussed individually with the addiction doctor.
Implant
In some cases, the medication is given as an implant placed under the skin under the sterile conditions of the treatment room. The procedure is performed under local anesthesia and takes about half an hour. The preparation requirements are the same: no opioids, an examination and consent. After placement, there is a follow-up check of the insertion site and regular follow-up by an addiction doctor.
Psychotherapy and rehab
A blockade protects against the effect of the substance, but it does not teach a person to live without it. That is why we also offer addiction psychotherapy, work with the family and, if needed, a rehab program. We discuss triggers, new ways of coping with stress and a plan for moments of strong craving. As the end of the period approaches, we decide whether to extend the blockade and how to reduce the risk of overdose.
Myths and facts
MythWith a blockade, you don’t have to worry about an overdose
FactQuite the opposite: trying to overcome the blockade with a large dose is life-threatening, and after it wears off, tolerance is reduced and the usual amount can be fatal. This is one of the main reasons why a blockade is combined with psychotherapy and follow-up.
MythA blockade can be given right after withdrawal
FactThe antagonist is given only after opioids have been fully cleared from the body and this has been confirmed by a test. If it is given earlier, severe withdrawal will begin. That is why the doctor sets the timing, and rushing is not acceptable.
MythA blockade will cure addiction with a single shot
FactA blockade reduces the risk of relapse while it is in effect, but it does not remove the causes of addiction. Without psychotherapy, support and changes in a person’s life, relapse remains likely once the period ends.
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
| Consultation and assessment before the procedure | 10 000 ₸ |
| Procedure (standard) | 50 000 ₸ |
| Procedure (extended) | 80 000 ₸ |
| 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
in Almaty 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 many days after quitting can a blockade be given?
The timing depends on which substance was used and for how long, and it is determined by the doctor. For short-acting opioids, at least a week is usually needed; for long-acting ones, longer. A test is always done before the procedure, and if there are doubts, a challenge test under a doctor’s supervision.
Can a blockade be given at home?
No, we give the blockade at the clinic: tests are needed, sometimes a challenge test, and readiness to help in case of an unexpected reaction. The Narcology 24 mobile team helps at the previous stage — treating withdrawal at home in any district of Almaty or the suburbs — and then you come in for the procedure.
How long does a blockade last?
The duration depends on the form of the medication: a long-acting injection and an implant work for different lengths of time. The doctor tells you the specific duration before the procedure, based on the chosen form. When it wears off, the blockade can be extended if the person and the doctor consider it helpful.
What should we do if the person uses while on a blockade?
Do not try to “top up” the dose — this is life-threatening. With drowsiness, slow breathing, bluish lips or loss of consciousness, call 103 or 112 immediately. If the person’s condition is stable, contact the doctor anyway: a relapse is a reason to reconsider treatment, not to stop it.
Do you help young people?
Yes. Minors receive treatment with the consent of a legal guardian, and we involve the family in the work. Teenagers and young people can anonymously call the free 150 helpline if they are not yet ready to tell their parents about their problem.
Is it anonymous?
Yes. The blockade is given anonymously, without state dispensary registration. Information about treatment 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 expressly provided for by the law of the Republic of Kazakhstan.
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