Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- ICD-10 code
- F11.2
- Who provides care
- An addiction physician; a psychotherapist works with the patient and the family
- Where
- At the clinic in Astana after detox, in a treatment room
- Duration
- The procedure takes 30–60 minutes; the period of effect is discussed with the doctor
- Anonymity
- Medical confidentiality under the Code of the Republic of Kazakhstan, no registration with the state dispensary
- When it is urgent
- Slow breathing, blue lips, loss of consciousness — call 103 or 112 immediately
- Outcome
- Reduced cravings and protection from the effects of opioids for the chosen period
What you should know
When a loved one has been through withdrawal and detox, the family feels relief and fear at the same time: what if they start again? A blockade is one way to reduce this risk. The antagonist medication occupies the opioid receptors, so using opioids no longer brings the usual effect. Here we explain how it works, why a blockade cannot be done “right away,” how to prepare your loved one, and how the family should behave in the first months after the procedure.
In Astana, families often find out about opioid use late, and the person themselves fears publicity, registration and the police. We work anonymously, on a paid basis, and information about the patient is protected by medical confidentiality. The Narcology 24 doctor sees patients at a clinic that is easy to reach from both banks — from Yesil, Nura, Saryarka, Almaty and Baikonur districts, as well as from Kosshy and Koyandy. Relatives can start with an online consultation.
When a family should discuss opioid blockade with a doctor
- your loved one has completed detox and wants to stay drug-free
- after previous attempts to quit, relapse happened within the first weeks
- the person is asking for “protection” from cravings at difficult moments
- they have not used opioids for the required period and are ready to take a test
- there is no serious liver disease and no acute mental disorder
- the person is ready for psychotherapy and regular contact with the doctor
- the family wants to understand how to support them without turning into wardens
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 opioid blockade works and why preparation matters
Opioid receptor antagonists bind to the same receptors that opioids act on but do not activate them. While the medication is working, using opioids does not produce the usual effect, and cravings gradually decrease. This approach is described in international guidelines, including WHO recommendations, as one option for maintenance therapy after detox — provided the patient is motivated.
If an antagonist is given to someone who still has opioids in their body, a sudden and severe withdrawal syndrome will begin. That is why completed detox, a period without use and a test are mandatory. Another important risk: after a blockade, tolerance to opioids falls, and an attempt to “override” the blockade with a large dose can end in a fatal overdose. The family needs to know this and discuss it openly.
How opioid blockade works: steps for the patient and the family
First comes a consultation — for relatives, it can be online: the doctor will explain how the blockade works, how long a period without use is needed and how to prepare your loved one. Then the patient comes for an in-person appointment: an examination, tests, a liver assessment and an opioid test. Sometimes the doctor carries out a challenge test to make sure withdrawal is complete. After the informed consent form is signed, the medication is given. The doctor explains the restrictions and arranges follow-up meetings.
A blockade is not carried out if the person has used opioids recently or is being treated with opioid medications, or in cases of serious liver disease, acute mental disorders, pregnancy, allergy to the medication, or without the patient’s consent. If after the blockade your loved one uses a substance and becomes drowsy, breathes slowly or their lips turn blue, call 103 or 112 immediately. Teenagers can get help from the 150 helpline.
How we help
Preparation and detox
A blockade is always preceded by completed detox. The doctor clarifies which substances were used, when last, and whether there have been overdoses, and checks liver function. An opioid test and, if necessary, a challenge test confirm that the medication can be given without the risk of triggering severe withdrawal. Rushing is dangerous here.
Giving the antagonist
Medications from the opioid receptor antagonist group are used — as tablets, long-acting injections or implants. The form and period are chosen with the doctor, taking into account the patient’s lifestyle and motivation. Specific doses and brand names are determined only by the doctor, after a workup and consent.
Psychotherapy and relapse prevention
A blockade removes part of the risk, but cravings are also tied to emotions, stress and surroundings. A psychotherapist helps the person recognize triggers, cope with anxiety and build a new social circle. Without this work, the likelihood of returning to use once the medication wears off is high. Sessions can also be held online.
Family support
At Narcology 24, relatives can have consultations with a psychologist: how to talk without blame, how to respond to signs of relapse, and how not to lose your own life in endless control. It is especially important to know about the risk of overdose after a blockade and not to leave your loved one alone if you suspect use. This is a real risk.
Myths and facts
MythA blockade can be given right after drug use
FactThis is dangerous: the antagonist will cause sudden and severe withdrawal. A blockade is carried out only after completed detox, a period without use and a test. The timing is set by the doctor. There is no need to rush the doctor.
MythA blockade can be “overridden” with a large dose
FactAn attempt to overcome the blockade with a high dose of opioids can lead to a fatal overdose, especially as the medication wears off. Both the patient and the family need to know this. If there are signs of an overdose, call 103 or 112.
MythAfter a blockade, the person will never use again
FactA blockade works for a limited period and reduces the risk of relapse, but it does not eliminate the reasons for use. Psychotherapy, support from loved ones and lifestyle changes are needed. We make no promises of “forever.”
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
| 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
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
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
How long must the person stay off opioids before a blockade?
The period depends on the substance and the length of use — usually at least 7–10 days after the last dose, sometimes longer. The exact period is set by the doctor. An opioid test is always done, and sometimes a challenge test as well, to rule out severe withdrawal after the medication is given.
For how long is a blockade given?
It depends on the form of the medication: tablets are taken daily, while long-acting injections and implants last longer. The period is discussed between the doctor and the patient. It is important that the choice is realistic and backed by psychotherapy.
How can the family tell that the person is using again?
The signs vary: changes in sleep and mood, constricted pupils, drowsiness, disappearing money and belongings, lies. Do not carry out searches or interrogations. Calmly say what you see and suggest calling the doctor together. If there is drowsiness and slow breathing, call 103 or 112.
Can painkillers be taken during a blockade?
Opioid painkillers do not work during a blockade. If surgery or dental treatment is needed, be sure to tell the doctors about the blockade. Carry information about it with you. Other painkillers are prescribed by the doctor with the blockade in mind.
What should relatives do if their loved one refuses?
Do not pressure them or issue ultimatums. Keep in touch and talk about your feelings and concerns. Take care of yourself: a consultation with a psychologist for relatives, including online, helps you get through this period. The decision about treatment is made by the person themselves.
Will the clinic report to the police?
No. Addiction care on a paid anonymous basis is protected by medical confidentiality under 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. Our job is treatment, not punishment.
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