Reviewed byZhanar Tulegenova, MDPsychiatrist and psychotherapist, experience 18 years · updated 8 Nov 2026
Key facts
- Who provides care
- A psychotherapist, an addiction doctor (narcologist), and a psychiatrist if needed
- Where
- Sessions at the clinic in Almaty, online by video, doctor home visits in case of relapse
- Duration
- Usually 6–12 months, with sessions from once a week to once a month
- Anonymity
- Anonymous, with no registry entry and full medical confidentiality
- When it is urgent
- A severe relapse, an overdose, seizures, or suicidal thoughts — call 103 or 112
- Outcome
- Consolidated sobriety, timely help when relapse risk rises, and a return to normal life
What you should know
Told by the on-call doctor of our mobile team. Discharge from rehab is not the finish line — it is the most vulnerable moment. The person returns to the same apartment in the Alatau district, the same neighbors, the same job. For three months at the clinic, they were in a safe environment, and now every day they decide for themselves whether to walk past the liquor store. Most of the repeat calls I see at night happen in the first weeks and months after discharge, especially if aftercare was not arranged.
That is why we try to make sure there is no gap between discharge and real life. Before discharge, a plan is drawn up: when the first session with the psychotherapist will be, whom to call when a craving hits, and when the follow-up visit to the doctor is. If the person lives outside the city, in Kaskelen or Konaev, we move most sessions online. And if a relapse does happen at night, the dispatcher sees that the patient is ours, and I go out already knowing their history — this saves time and helps bring the person back into the program quickly.
Who Needs Aftercare Most
- people recently discharged from inpatient rehab
- those who relapsed after previous courses of treatment
- patients with co-occurring depression, anxiety, or insomnia
- those returning to a social circle in which drinking or drug use continues
- people recovering from opioid addiction, because of the risk of overdose
- those returning to work after a long break
- families who do not know how to support a loved one after discharge
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 Aftercare Following Rehab Matters So Much
The first year after treatment is the period of highest relapse risk. Addiction-related changes in brain function recover slowly, and life after discharge is full of stress: debts, work, relationships, old acquaintances. The WHO and international guidelines regard addiction as a chronic disease and recommend long-term support after the intensive stage, similar to follow-up care for other chronic illnesses.
The risk is especially high after rehab for opioid addiction: tolerance decreases, and a dose the person used to take can become fatal. Regular follow-up helps spot the early warning signs of relapse — irritability, insomnia, missed sessions — and intervene before any use occurs. Support from the family and mutual support groups reduces isolation, which is a risk factor in itself.
How Aftercare Works
Before discharge, the psychotherapist and the addiction doctor draw up an aftercare plan. For the first 1–3 months, there are weekly sessions with the psychotherapist, in person or online, plus a support group. The addiction doctor holds follow-up visits every 2–4 weeks: assessing health, continuing maintenance treatment when indicated, and, with consent, carrying out alcohol or drug tests. After that, sessions become less frequent. If the person’s condition worsens, the intensity of aftercare is increased.
Aftercare does not replace emergency care. In case of a severe binge, an overdose, seizures, psychosis, or suicidal thoughts, call 103 or 112. A relapse with marked withdrawal requires detox — at home or in the inpatient unit, depending on the person’s condition. Online sessions are not suitable for assessing physical health or prescribing medication — an in-person visit is needed for that.
How we help
Supportive psychotherapy
Regular sessions with a psychotherapist who knows the patient’s history from rehab. Current difficulties, risks, and successes are discussed. Relapse prevention skills are practiced in real-life situations: at work, in the family, at celebrations. Sessions gradually become less frequent, but they do not stop abruptly — they are wound down by mutual agreement.
Medical follow-up
A Narcology 24 addiction doctor monitors the person’s overall condition, the recovery of the liver and other organs, and sleep, and continues anti-craving treatment if needed. If there are co-occurring mental health disorders, a psychiatrist provides follow-up. Regular visits make it possible to spot a deterioration before it leads to relapse.
Support groups
Patients who have completed rehab attend the clinic’s psychotherapy groups in person or online, as well as mutual support fellowships in Almaty. A group helps them not to be left alone with their difficulties and to see the example of people with longer sobriety. Online groups are convenient for residents of the suburbs and those who work late.
Social reintegration and help for the family
The psychotherapist helps plan a return to work or studies, build a daily routine, and find new interests and a sober social circle. The family receives consultations: how to support without controlling, how to talk about difficulties, and what to do at the first signs of relapse. Family sessions help rebuild trust that has been undermined by years of addiction.
Myths and facts
MythAfter rehab, the person is already healthy
FactRehab lays the foundation, but the risk of relapse remains high during the first year. Aftercare helps consolidate the result, just like follow-up care after treatment for other chronic diseases.
MythIf you relapse after rehab, it was all for nothing
FactA relapse does not cancel out the skills gained in rehab. Returning to treatment quickly usually leads to a shorter relapse and a longer remission afterward. The main thing is not to hide the relapse and to contact a doctor right away.
MythAftercare means constant control and checks
FactAftercare is based on cooperation, not surveillance. Tests are carried out only with the patient’s consent, and sessions are there to support and help, not to catch anyone out. The frequency of sessions is chosen together with the person.
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
| Rehab programme consultation | 12 000 ₸ |
| Outpatient programme (one month) | 150 000 ₸ |
| Residential rehab (one month) | 400 000 ₸ |
| 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 almaty you can get help at home, at one of our two branches (84 Zhandosova St., Almaty, 21 Seyfullina Ave., office 11, Almaty) 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 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 long does aftercare following rehab last?
Usually 6 to 12 months, sometimes longer. In the first months, sessions are weekly, then every 2–4 weeks. The duration depends on the severity of the addiction, whether there have been relapses, and co-occurring disorders, and it is discussed with the psychotherapist.
Can I receive aftercare if I went through rehab at another center?
Yes. The psychotherapist and the addiction doctor will carry out an initial assessment, review your discharge summaries and treatment plan if you have them, and draw up an aftercare program. This is convenient if you completed rehab in another city and have returned to Almaty. The first session can be held online.
What should I do if I feel a strong craving?
Follow the plan you drew up with your psychotherapist: call your specialist, your sponsor, or a loved one, leave the risky situation, and ride out the wave of craving. If the craving does not subside or you have used, call the clinic — the doctor will help and, if needed, make a home visit.
Can aftercare be done online?
Most sessions can take place by video, which is convenient for people who work, study, or live outside the city. In-person visits are needed for a doctor’s examination, lab tests, and prescribing medication. The format is discussed at discharge and can change over the course of aftercare.
Why is a relapse especially dangerous after rehab for opioid addiction?
After a break, tolerance decreases, and a dose the person used to tolerate can cause an overdose and respiratory arrest. If after using the person does not wake up, breathes slowly, or their lips turn blue, call 103 or 112 immediately.
Is it anonymous?
Yes. Aftercare is provided anonymously, with no registry entry. Medical confidentiality is protected by the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System.” Information is disclosed only in cases expressly provided for by law, and your employer will not find out about your treatment.
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
