Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- Who provides it
- An addiction doctor and a psychotherapist trained in motivational interviewing
- Where
- At the clinic, in your home in any district of Astana, or by video
- Duration
- Family preparation — 1–3 sessions; the conversation with the person — about an hour
- Anonymity
- Complete, with no documents and no registration
- When it is urgent
- Psychosis, suicidal thoughts, overdose — call 103 or 112 without waiting for consent
- Outcome
- Voluntary agreement to a consultation, detox, or inpatient treatment
What you should know
The most common question relatives ask when they call is: “How can I make him get treatment?” The honest answer is that under the law of Kazakhstan, an adult cannot be forced; involuntary treatment is possible only by court decision. But that does not mean the family is powerless. There are proven ways to help a person reach the decision on their own, and most of them begin with changes in the behavior of loved ones rather than with endless persuasion.
Many families in Astana try to resolve the issue in a hurry: between work, traffic jams, and household chores, it seems that one tough conversation should be enough. But ultimatums, tears, and scenes more often increase resistance. Narcology 24 specialists help you prepare for the conversation, choose the moment, find the words, and agree in advance where the person can go immediately after agreeing — before their resolve fades and is replaced by the usual “tomorrow.”
Signs a Person May Be Ready to Talk
- he himself complains about his health, sleep, or problems at work after drinking
- after a bad episode, he feels ashamed and says “never again”
- he is curious about how others got treatment or asks about alcohol coding
- he is afraid of losing his family, his job, his driver’s license, or his children
- he has tried to quit on his own but could not last even a week
- he has started to worry about his heart, his liver, or his memory
- he argues less when the conversation turns to his drinking or drug use
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 Refuse Treatment
Denial is not stubbornness — it is part of the disease. Addiction changes perception: the person sincerely believes they drink “like everyone else,” or fears that without the substance they will not be able to cope with anxiety and insomnia. Another reason is fear: of the registry, of people finding out, of withdrawal pain, of the unknown. When the family understands these reasons, it can address them directly instead of arguing about the fact of substance use itself.
Often the family itself unintentionally supports the refusal. If the consequences of a binge are always smoothed over — debts paid off, the boss deceived, the home cleaned up — the person has no reason to change anything. The motivational approach suggests carefully returning responsibility for the consequences to the person, while preserving warmth, respect, and the safety of all family members.
How Motivational Work Proceeds, Step by Step
First, the specialist meets with the relatives, often online: goes over the history, past attempts, and the family’s strengths. Then together you choose the moment and form of the conversation — when the person is sober, calm, and without witnesses. The family agrees in advance where the person will go if they agree: a consultation, a doctor’s home visit, or an inpatient unit. If needed, the specialist comes to your home and holds the conversation in person.
Motivational work is not appropriate for acute conditions. If the person is psychotic, talks about suicide, or has seizures, confusion, or signs of an overdose, call 103 or 112 without waiting for their consent. If there is a threat of violence, first ensure your own and your children’s safety. Compulsory treatment is possible only by court decision; the clinic does not take people away by force.
How we help
Motivational interviewing
This is a conversational method recommended by international guidelines for addiction. The specialist does not argue or try to convince, but helps the person put into words what they are losing because of substance use and what they want. When the arguments come from their own mouth, the decision becomes their own rather than imposed. The method is used both by the doctor and by trained relatives.
Family preparation based on CRAFT principles
Relatives learn to reward sober behavior, not to reward substance use, to allow natural consequences to occur, and to take care of themselves. This approach is described in the scientific literature as an effective way to bring a loved one into treatment. The specialist adapts it to your situation and to your real conversations.
A family meeting with a specialist present
When the family is ready, a conversation can be arranged with an addiction doctor present. Everyone speaks about their own feelings and observations, without accusations, and offers specific help. The specialist makes sure the meeting does not turn into a trial. This is a gentle alternative to harsh interventions, which often backfire.
A ready-made route right after agreement
A person’s resolve may vanish within a few hours, so it is important to take action immediately. At Narcology 24, a doctor’s home visit, a bed in the inpatient unit, or a consultation time is arranged in advance. If the person lives outside the city, for example in Kosshy or Koyandy, the logistics are worked out even before the conversation, so that the precious moment is not lost.
Myths and facts
MythYou have to wait until he hits rock bottom
FactEveryone’s “rock bottom” is different, and sometimes it turns out to be fatal. Waiting is dangerous, especially with opioids and synthetic drugs. Motivational work can begin at any moment, and the family can bring the decision closer without waiting for a disaster.
MythYou can trick him into getting coded
FactAlcohol “coding” (a treatment widely used in Kazakhstan and CIS countries) and any blockades are carried out only with written informed consent, after tests and the required period of sobriety. Deception destroys trust and almost always ends in relapse. An honest conversation works for longer.
MythA harsh ultimatum is the best approach
FactUltimatums help only if you are prepared to carry them out. Empty threats teach the person that words mean nothing. It is better to think through realistic boundaries in advance and hold them calmly than to make promises in the heat of emotion.
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 Astana
| 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
In astana you can get help at home, at one of our two branches (6 Auezova St., office 37, Astana, 176 Imanova St., Astana) 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 Astana 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
Can an adult be admitted to a clinic without their consent?
No. Under the law of the Republic of Kazakhstan, involuntary treatment is possible only by court decision in the established procedure. A private clinic cannot and should not take a person away by force. If there is a threat to life, call 103 or 112 — emergency care is provided based on medical need.
When is the best time to start the conversation?
Choose a moment when the person is sober, not in a hurry, and not irritated — for example, on a weekend morning after a bad episode, when they themselves feel guilty. Do not start the conversation when they are intoxicated, in front of the children, or in the heat of emotion. Think through in advance exactly what you will say and what you will offer.
What should I say, and what should I avoid saying?
Talk about your feelings and specific facts: “I was frightened when you didn’t come home last night.” Avoid labels, insults, and bringing up every past grievance. Offer one concrete step — a single consultation, not “a whole life without alcohol.” The specialist will help you rehearse the conversation.
What should I do if he refuses?
Do not argue, and do not repeat your pleas in circles. Say that the offer still stands, and return to your own plan: boundaries, self-care, support for the children. A refusal today does not mean a refusal forever. Many people agree after the second or third calm conversation.
Can a specialist come and talk to him instead of us?
Yes, an addiction doctor or psychotherapist can come to your home in any district of Astana if the person is willing at least to listen. But the best results come when the family is prepared in advance and takes part. The specialist is not a magician but a helper who makes it easier for the conversation to work.
Does motivational work help with drug addiction?
Yes, motivational approaches are used for all types of addiction. With drugs, it is especially important to take the risks into account: overdose, psychosis, infections. If you see signs of a dangerous condition, do not wait for consent to treatment — call 103 or 112. The 150 helpline is available for teenagers.
Where do doctors visit in Astana and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 6 Auezova St., office 37, Astana and 176 Imanova St., Astana. Phone in Astana: +7 (700) 309-30-17.
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
