Dual diagnosis: addiction and mental illness in Almaty

Reviewed byOlga Smirnova, MDAddiction psychiatrist, experience 27 years · updated 8 Nov 2026

Key facts

Who provides care

A psychiatrist and an addiction doctor together, with a psychotherapist involved

Where

Home visits in Almaty and the suburbs, inpatient unit, online follow-up

Duration

Detox 3–7 days, main treatment from several months

Anonymity

No entry in the state addiction or psychiatric registry

When it’s urgent

Delirium tremens, seizures, overdose, suicidal thoughts — call 103 or 112

Outcome

Lasting sobriety and control of mental health symptoms

What you should know

On night calls, we see dual diagnosis all the time, even though relatives have never heard the term. They call about a drinking binge, and in the apartment I find a person who drinks because otherwise anxiety won’t let them sleep. Or we are called to a son who is “acting strangely,” and it turns out he has also been using stimulants. In such cases, the dispatcher always asks about substances and about previous diagnoses — this determines who goes: an addiction doctor, a psychiatrist, or both.

The main difficulty is that one problem masks the other. Alcohol relieves anxiety and low mood for a while and then makes them three times worse. Hangover depression looks like the real thing, and withdrawal insomnia looks like a symptom of psychosis. That is why I don’t make final diagnoses in the first 24 hours: first comes safe detox, sleep, and observation. Only after one or two weeks of sobriety does it become clear what remains once the substance has left the body, and what treatment is really needed.

Signs that a mental disorder lies behind the addiction

• the person drinks or uses to dull low mood, anxiety, or insomnia
• after coming off a binge, depression and thoughts that life is meaningless last for weeks
• periods of “manic energy” alternate with binges and complete exhaustion
• voices, suspiciousness, or fear of being followed appear during substance use
• relapses happen after traumatic events, nightmares, or memories
• the person has been treated for addiction before, but each time it ended in a quick relapse
• there are relatives in the family with depression, bipolar disorder, schizophrenia, or addiction

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 addiction and mental disorders go hand in hand

The link works both ways. A person with unrecognized depression, anxiety, or PTSD finds quick relief in alcohol and gradually becomes dependent. This is called self-medication, and it almost always ends worse than it began. On the other hand, substances themselves change how the brain works: long-term heavy drinking and stimulants trigger depression, anxiety, and psychotic episodes, especially in people with a hereditary predisposition.

The shared risk factors are the same, too: severe stress, childhood trauma, chronic loneliness, and family history. International guidelines, including those from NICE and the WHO, recommend treating both disorders at the same time by one team. If only the addiction is treated, untreated depression pushes the person toward relapse. If only the depression is treated, alcohol cancels out the effect of the medication and raises the risk of suicide.

How we help

Myths and facts

How a home visit works

1. 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.
2. 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.
3. 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.
4. 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.
5. Further treatmentCoding, psychotherapy, rehab or psychiatric follow-up — once the acute state has passed and the person is ready.

Prices in Almaty

The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.

Where to get help

“Dual diagnosis: addiction and mental illness” in Almaty is available 24/7, including weekends. Home visits: all city districts and nearby settlements. For appointments, Narcology 24 has two branches: 84 Zhandosova St., Almaty and 21 Seyfullina Ave., office 11, Almaty. If you live elsewhere in Almaty and Almaty Region, call us and we'll advise the fastest way to get help.

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