Reviewed byNurlan Isayev, MDAddiction psychiatrist, experience 10 years · updated 8 Nov 2026
Key facts
- Who provides care
- Psychotherapists, an addiction doctor (narcologist), and a psychiatrist if needed
- Where
- Sessions at the clinic in Almaty and online by video, doctor home visits if the condition worsens
- Duration
- Usually 2–6 months, with 2–4 sessions a week at the start and fewer later on
- Anonymity
- Anonymous, with no registry entry; online sessions are not recorded
- When it is urgent
- Severe withdrawal, seizures, psychosis, or suicidal thoughts — call 103 or 112
- Outcome
- Sobriety without taking time off work or leaving the family, and relapse prevention skills
What you should know
Told by the on-call doctor of our mobile team. After a night call, many patients say: “I can’t go inpatient — I have work, kids, a loan to pay.” That is an honest argument, and for some people an outpatient program really is the right fit. The day after alcohol detox or withdrawal relief, we call back, and I ask questions: has there ever been delirium or seizures, is there alcohol or drugs at home, who lives with you, does the family support you, and how long will it take to get to the clinic.
In Almaty, that last question is not a formality. In the evening, the drive from the Alatau district or from Otegen Batyr to the city center can take more than an hour, and traffic jams on Ryskulov Avenue or Sain Street kill any desire to go to a group session. That is why we move some sessions online. But I always warn patients: an outpatient program requires more independence than an inpatient one. If after two or three weeks it becomes clear that staying sober at home is not working, we honestly suggest switching to the inpatient format.
Who the Outpatient and Online Format Is For
- detox has already been completed, and there are no acute withdrawal symptoms
- no history of delirium, seizures, or psychosis during withdrawal
- stable physical health, with no serious liver or heart disease
- there is support at home, and no one close to the person is actively drinking or using
- the person wants to keep working or studying and is ready to attend sessions
- stepping down from inpatient care to the maintenance stage of treatment
- living outside the city or in another city where in-person sessions are difficult
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 Outpatient Rehab Works
Addiction develops in real life — at home, at work, with friends — and sobriety skills are also best reinforced there. An outpatient program lets the person immediately apply what was discussed in a session: turning down a drink at a company party, walking past the usual liquor store, talking to their wife without an argument. International guidelines, including NICE, regard outpatient psychosocial interventions as the main format for many patients.
The online format expands access: a person can take part from home in Kaskelen, on a business trip, or during a night shift. Research on telemedicine in addiction treatment shows that video psychotherapy sessions are comparable to in-person ones for many patients. But online sessions do not replace an in-person examination, lab tests, and prescribing medication, so the program always includes in-person visits to the doctor.
How the Outpatient and Online Program Is Structured
It starts with an in-person consultation with an addiction doctor and a psychotherapist: examination, lab tests, risk assessment, and goal setting. For the first 4–6 weeks, there are 2–4 sessions a week: individual psychotherapy, group therapy, and a doctor’s visit if needed. Some sessions take place by video at a convenient time, including in the evening. The patient keeps a craving and mood diary. Then the frequency drops to once a week and later to maintenance sessions. The family receives consultations in parallel.
Outpatient detox is not possible with severe withdrawal, a history of delirium or seizures, polysubstance addiction, psychosis, marked depression with suicidal thoughts, serious illnesses, or the absence of a sober environment at home. In these cases, inpatient care is needed. If there is a threat to life, call 103 or 112. Online sessions are not suitable for assessing physical health or prescribing medication.
How we help
Individual psychotherapy
Weekly sessions with a psychotherapist, in person or online. Cognitive behavioral therapy, motivational interviewing, and relapse prevention techniques are used. The patient goes over real situations from the past week and learns to recognize cravings and find alternatives to drinking or drug use. A session lasts about an hour, and the schedule is adjusted to fit around work.
Group therapy
Groups of several people with similar problems, led by a psychotherapist. Participants share their experience and receive support and feedback. Many say it is the group that helps them feel they are not alone. There are in-person groups at the clinic and online groups for those who live in the suburbs or work late.
Medical monitoring
A Narcology 24 addiction doctor holds regular in-person visits: assessing health, prescribing medications that reduce cravings and treatment for insomnia and anxiety when indicated, and, with consent, carrying out alcohol or drug tests. If the person’s condition worsens or they relapse, the doctor can make a home visit at any time of day or night, without waiting for the next scheduled appointment.
Working with the family
Loved ones take part in several sessions: they learn how to support sobriety without controlling, how to talk about a relapse, and what to do about alcohol at home. This is especially important in the outpatient format, where the person is with the family every day. Family sessions can be held online if relatives live in different districts or cities.
Myths and facts
MythOutpatient rehab is a “lite” version that isn’t serious
FactFor many patients, the outpatient format is just as effective as the inpatient one, provided patients are selected correctly. It requires more independence but allows skills to be reinforced in real life.
MythOnline therapy is just talking — it doesn’t help
FactVideo sessions use the same methods as in-person ones: CBT, motivational interviewing, and relapse prevention. For many people they are comparable in effectiveness, as long as they are combined with in-person visits to the doctor.
MythIf you started as an outpatient, you can’t switch to inpatient care
FactYou can switch at any time. If staying sober at home is not working, the doctor will recommend an inpatient stage, and after it, a return to the outpatient program. The format is adapted to the patient’s condition.
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
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
Can rehab be completed entirely online?
Most of the psychotherapy, yes, but the initial examination, lab tests, and prescribing medication require an in-person visit to the doctor. We recommend a combination: online sessions and groups plus periodic in-person appointments. Follow-up support after the main stage can be entirely online.
How much time does the program take each week?
At the start, usually 2–4 sessions of an hour to an hour and a half, sometimes more. After 1–2 months, the frequency decreases. Sessions can be scheduled in the evenings and on weekends so you do not have to interrupt work. The exact schedule is agreed at the first consultation.
What should I do if I relapse?
Tell your doctor or psychotherapist right away, without waiting for the next scheduled session. In case of a binge or severe withdrawal, the doctor will make a home visit at any time of day or night. Then the psychotherapist will help work out the cause of the relapse and, if needed, intensify the program or switch to inpatient care.
Is the outpatient format suitable for drug addiction?
Sometimes, yes — more often as a continuation after the inpatient stage. With active drug use, polysubstance addiction, or psychosis, starting as an outpatient is unsafe. The doctor will assess the situation individually and recommend a suitable format.
Are online sessions confidential?
Yes. Sessions are held over secure channels, are not recorded, and are covered by medical confidentiality. Treatment is anonymous, with no registry entry. For a session, it is best to choose a place where no one can overhear you — this matters for an open conversation.
Do I need detox before the program?
Yes, if there is physical dependence and signs of withdrawal. Detox at home or in the Narcology 24 inpatient unit is carried out before the program begins. Without it, it is hard to focus on psychotherapy, and the risk of complications and relapse in the first days is higher.
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
