Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- Who provides care
- An addiction physician; a psychotherapist for psychotherapeutic methods
- Where
- At the clinic in Astana; implant removal is done in a treatment room
- Duration
- Consultation and procedure usually take from 30 minutes to 2 hours
- Anonymity
- No state registry, medical confidentiality under the law of the Republic of Kazakhstan
- When it is urgent
- If the person drank while the coding is still active and feels unwell — call 103 or 112
- Outcome
- Safe termination of the method and a discussion of further treatment
What you should know
Relatives may feel anxious and hurt when a loved one says, “I want to be decoded.” It seems that all the effort has been in vain and the binges will come back. But the reasons vary: medications incompatible with the coding drug, surgery, pregnancy, distress caused by the constant fear of a reaction. And sometimes it is the wish to drink. This page is for the family: how to talk to the person about their decision, what the doctor does, and why “decoding” yourself is dangerous.
In Astana, we see people who were given alcohol “coding” (a treatment widely used in Kazakhstan and CIS countries) in other cities — in the regions they moved from — and who do not know exactly which medication they were given. This is an important detail for the doctor. The Narcology 24 addiction doctor holds a consultation, finds out the coding method and period, assesses the person’s condition and explains the risks. We see patients from all districts — the left and right banks, Yesil, Saryarka, Nura and Baikonur — as well as from Kosshy and Koyandy.
When decoding may be needed
- the person needs to take medications that are incompatible with the coding drug
- surgery, general anesthesia or major dental treatment is coming up
- a pregnancy is planned or the patient is already pregnant
- constant fear of a reaction interferes with life; anxiety and insomnia have appeared
- the person wants to switch to a different method of addiction treatment
- the implant causes inflammation, pain or discomfort at the insertion site
- the person has firmly decided to drink and may do so without a doctor, putting their life at risk
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 you should not try to “decode” yourself
With medication-based coding and chemical protection, a medication remains in the body that causes an unpleasant and sometimes dangerous reaction when alcohol is consumed: a drop in blood pressure, heart rhythm disturbances, breathlessness. Attempts to “override” the coding with alcohol or folk remedies, or to cut out an implant at home, can end in intensive care. Only a doctor who knows which medication was given can safely end the method’s effect.
With psychotherapeutic methods, such as the Dovzhenko method, there is no physical reaction, but the commitment instilled can cause severe anxiety. A conversation with a psychotherapist removes it. Many newcomers to Astana were coded in the regions and do not remember the name of the method — in that case, the doctor questions the patient and relatives in detail, looks for medical records and only then decides how to proceed safely.
How decoding works: steps for the patient and the family
First comes a consultation; relatives can join online or come together with the patient. The doctor finds out when and by what method the coding was done, whether there are documents, and why the person wants to be decoded. At the in-person appointment, he carries out an examination and, if necessary, tests and an ECG. What follows depends on the method: medications that speed up elimination are prescribed, the implant is removed under local anesthesia, or a session with a psychotherapist is held.
The procedure is postponed if the person is currently drunk, or if they drank while the coding was active and feel unwell — then emergency care is needed: call 103 or 112. In people with serious heart, liver or kidney disease, decoding is carried out with particular caution, sometimes in an inpatient unit. The doctor does not carry out the procedure without the patient’s consent at the request of relatives alone.
How we help
Identifying the coding method
The doctor asks where, when and how the coding was done and asks to see documents or medical records. Relatives often remember the details better: the name of the clinic and the type of procedure — an injection, a drip, an implant or a session. Without this information, the doctor chooses the safest approach and may order additional tests.
Medication-based decoding
For chemical protection and injection-based coding, the doctor may prescribe medications that speed up elimination or weaken the effect of the drug that was given, as well as IV drips to support the body. The specific regimen depends on the medication and the person’s health. The doctor separately explains after how long drinking alcohol becomes safer.
Implant removal
If an implant is in place, it is removed in a treatment room under local anesthesia through a small incision. The procedure usually takes 20–40 minutes, after which the wound needs care. Never try to remove an implant yourself — this risks infection, bleeding and incomplete removal of the medication. Stitches are removed as the doctor instructs.
Talking about the way forward
Decoding is a good opportunity to discuss honestly what comes next. The Narcology 24 doctor will offer alternatives — another method, psychotherapy or rehab — if the person wants to stay sober. The family can get a consultation with a psychologist on how to cope with anxiety and not turn a loved one’s decision into an endless quarrel. This is also part of the help we provide.
Myths and facts
MythTo get decoded, it is enough to drink a little alcohol
FactThis is the most dangerous way. While medication-based coding is active, even a small amount of alcohol can cause a severe reaction. Safe decoding is carried out only by a doctor who knows the method and the medication.
MythDecoding means the treatment has failed
FactThe reasons can be medical: surgery, medications, pregnancy. And if the person wants to drink, it is better for them to do so after consulting a doctor than to risk their life. It is a reason to review the treatment, not to put an end to it.
MythPsychotherapeutic coding cannot be removed
FactWith the Dovzhenko method and other psychotherapeutic methods, the commitment is removed by a psychotherapist during a conversation. There is no physical reaction to alcohol in this case, but the anxiety is real, and it can be worked on.
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
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 a person be decoded at the request of relatives?
No. Decoding, like coding, is carried out only with the patient’s own consent. Relatives can come to the consultation, ask questions and support their loved one. If there is conflict over their decision, a psychologist will help you discuss the situation calmly.
How should I talk to a loved one who wants to be decoded?
Listen to their reasons without reproach. Share your concerns: “I’m afraid the binges will come back.” Suggest going to the doctor together — that way the person will at least do it safely. Threats and rows push people toward dangerous experiments with alcohol on their own.
What should we do if the person drank while the coding is still active?
If a hot flush, redness, a racing heart, shortness of breath, chest pain, weakness or loss of consciousness appear, call 103 or 112 immediately and say that the person has been coded. Do not let them try to “wash it out” with more alcohol, and do not leave them alone until the ambulance arrives.
How long does decoding take?
Consultation and procedure usually take from 30 minutes to 2 hours. Implant removal takes about 20–40 minutes. After medication-based decoding, the drug is not eliminated instantly, so the doctor explains how much longer the person should avoid alcohol to prevent a reaction.
Can I be decoded if the coding was done in another city?
Yes. Bring any documents you have. If there are none, the doctor will ask about the procedure in detail and, if necessary, order tests. Many patients in Astana were coded in the regions; this is a common situation that we resolve after a consultation.
Is anonymity preserved?
Yes. Decoding is carried out anonymously, on a paid basis, without registration with the state dispensary. The information is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System” and is disclosed only in cases expressly provided for by law.
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
