Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- Who provides care
- A psychotherapist and a family psychologist; an addiction doctor advises on your loved one’s illness and treatment options
- Where
- Appointments at the clinic in Astana, online consultations, support groups for relatives
- Duration
- First changes after 4–8 sessions; the full course of work takes 3 to 6 months
- Confidentiality
- Confidential, no registry; your loved one will not learn about the consultation without your consent
- When it’s urgent
- Threat of violence, or suicidal thoughts in you or your loved one — call 103 or 112; children and young people can call 150
- Outcome
- Clear boundaries, less anxiety and guilt, your own goals and strength, and a clear plan of action in a crisis
What you should know
If you are reading this page, you may have been living in a state of waiting for a long time: will he come home sober, will he answer the phone, has something terrible happened? You check his pockets, take time off work to pull him out of a binge, call his boss with excuses, and hand over your last money to pay his debts. Over time your own life disappears, and all that is left is the struggle for someone else. This is called codependency, and it is not your fault.
We see how often in Astana the whole family rests on one person: work from morning to night, children, elderly parents, and on top of that a loved one with addiction. Many people have moved here from other regions and have no relatives nearby to share the load. Help for relatives is not an add-on to treatment but a full part of it. You can come for a consultation even if your loved one still refuses treatment: changes within the family often become the first step toward their recovery.
Signs of codependency: do you recognize yourself?
- your whole life revolves around his drinking or drug use; you constantly think about where he is and what is happening to him
- you hide the problem from relatives and coworkers, make excuses, and lie for him
- you pay off his debts, call doctors, and solve the problems he has created
- you feel responsible for his relapses and guilty if you couldn’t prevent them
- you check his phone and pockets, search for bottles or pills, and live in constant tension
- you have neglected your own health, friends, and hobbies — “I have no energy or time for myself”
- insomnia, anxiety, tears, headaches, and a feeling that you are at your limit
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 codependency develops and why it is so hard to break free
Codependency builds up gradually, as a loving person’s natural reaction to chaos. You try to protect the family from the consequences, and it seems like the right thing to do. But over time, rescuing becomes a system: the addicted person never faces the consequences of their use, while you take on more and more. A vicious circle forms in which the roles of “victim,” “rescuer,” and “persecutor” keep switching places.
The risk is higher for those who grew up in a family with alcohol abuse or violence, who are used to caring for others at their own expense, and for people living in isolation — without the support of friends and far from relatives. Cultural expectations to “endure for the sake of the family” and fear of judgment also keep people stuck. It is important to understand that giving up rescuing is not a betrayal. It is a way to give your loved one a chance to face reality and want treatment.
How help for relatives works
The first consultation takes place in person in Astana or by video call, if it is more convenient to join from home or work. The psychotherapist will listen to your story and help you assess how exhausted you are and whether there are any safety threats to you and your children. Then comes a plan: regular individual sessions, family sessions if you wish, and groups for relatives. Separately, an addiction doctor will explain what illness your loved one has, what treatment options exist, and how to suggest them without a fight.
If there is physical violence in the family, threats with weapons, or you fear for your life, safety comes first: call 102 or 112, and go to relatives or a crisis center. If you yourself are thinking about suicide, or your loved one is in an acute state (psychosis, delirium, overdose), call 103 or 112. Online consultations suit most relatives, but an acute crisis requires in-person help.
How we help
Individual psychotherapy
We work with the anxiety, guilt, resentment, and fear that have built up over the years. The psychotherapist helps you separate your own responsibility from your loved one’s, learn to say “no,” and turn your attention back to your own health and life. Cognitive behavioral approaches and trauma-focused methods are used. Sessions take place once a week, in person or online.
Training in family strategies
There are proven approaches for relatives, such as Community Reinforcement and Family Training (CRAFT). They teach how to communicate with the addicted person, encourage sober behavior, avoid supporting substance use, and suggest treatment at the right moment. Research shows that such approaches increase the likelihood that a loved one will agree to get help.
Family therapy
When the addicted person is already in treatment, joint sessions help rebuild trust, share responsibilities, and agree on house rules. We discuss how to behave when there is a risk of relapse and how to talk with children about a parent’s illness. The family learns to live in a new way instead of going back to the old script after their loved one leaves the clinic.
Support groups for loved ones
Meeting others who are going through the same thing relieves the sense of loneliness and shame. We tell you about mutual support groups for relatives that follow the 12-step program, as well as therapeutic groups at the clinic. For many, it is there that they manage for the first time to say out loud what they have kept secret from everyone for years.
Myths and facts
MythIf I love him more, he’ll quit
FactLove matters, but it does not cure addiction. Excessive caretaking and rescuing often prolong substance use. What helps is a combination of love, clear boundaries, and professional treatment from a doctor.
MythOnly the addicted person needs help
FactThe family is part of the system, and when relatives change, the whole situation changes. Helping loved ones improves their health and increases the chances that the addicted person will seek treatment and stay sober.
MythSetting boundaries means abandoning the person
FactBoundaries are neither a punishment nor walking away. They are clear rules about what you are willing to do and what you are not. For example, you won’t give money, but you will pay for a doctor’s consultation. This way you preserve both the relationship and yourself.
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
| Initial addiction doctor consultation | 12 000 ₸ |
| Inpatient detox (per day) | 35 000 ₸ |
| Psychotherapy course (8 sessions) | 96 000 ₸ |
| 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
“Codependency: help for families” in Astana is available 24/7, including weekends. Home visits: all city districts and nearby settlements. For appointments, Narcology 24 has two branches: 6 Auezova St., office 37, Astana and 176 Imanova St., Astana. If you live elsewhere in Astana and Akmola Region, call us and we'll advise the fastest way to get help.
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 I come if my husband refuses treatment?
Yes, and it is one of the most useful steps you can take. The consultation is first and foremost for you: to reduce your anxiety, understand what is happening, and learn to act differently. Many families notice that after their own behavior changes, the person with addiction starts thinking about treatment.
How do I stop checking his phone and pockets?
It is hard, because control eases anxiety for a minute. A psychotherapist will help you replace control with other ways of coping with fear and agree on transparent rules. Gradually you will realize that you can’t influence his drinking or drug use by checking up on him — but you can regain your own peace of mind.
How do I explain to the children what is happening with Dad or Mom?
Speak honestly and in an age-appropriate way: “Dad is sick; this illness is called addiction, and it’s not your fault.” Don’t make the children keep the secret, and don’t turn them into your helpers in keeping watch. The specialists at Narcology 24 will help you find the right words and, if needed, consult the child.
What should I do if he left home drunk in winter?
The frost and wind in Astana are dangerous for an intoxicated person: hypothermia develops quickly and without warning. Call him and his acquaintances; if his life is at risk, or he isn’t answering and may be outdoors, call 112 or 102. Don’t search alone at night. Afterwards, discuss a plan with a psychotherapist.
Are consultations for relatives confidential?
Yes. Narcology 24 maintains medical confidentiality and does not share information with third parties, including your loved one, without your consent. There is no registry. Many people come without the addicted person knowing, and that is perfectly normal: what matters is that you get support.
How many sessions does it take to feel better?
Many people feel relief after the very first consultation, once they have understanding and a plan. Lasting changes usually come after 4–8 sessions, and the full course of work takes several months. The pace is individual: it is important not to rush yourself and to keep going, even if your loved one hasn’t changed yet.
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
