Polysubstance addiction in Astana

Reviewed byNurlan Isayev, MDAddiction psychiatrist, experience 10 years · updated 8 Nov 2026

Key facts

ICD-10 code

F19

Who provides care

An addiction medicine doctor, a psychiatrist for psychosis and depression, a psychotherapist, and a rehab counselor

Where

Inpatient care for detox, home visits in Astana when the condition is stable, online support for loved ones

Duration

Detox takes 7–14 days; treatment and rehab last 3 months or longer

Confidentiality

Medical confidentiality under the law of the Republic of Kazakhstan, paid anonymous treatment, no registry

When it’s urgent

Loss of consciousness, slow breathing, seizures, psychosis, chest pain — call 103 or 112 immediately

Outcome

Recovery from the acute state, a treatment plan, rehab, and support for the family

What you should know

Families often learn about polysubstance addiction only after something bad has already happened: an ambulance call, an arrest, debts. Before that, they saw strange shifts in the person’s state — agitation one moment, heavy drowsiness the next, sometimes the smell of alcohol, sometimes pills in a pocket. The person may claim they “just had a drink,” when in fact they were mixing several substances. If this picture sounds familiar, it is important to act calmly and quickly: such combinations are a real threat to life.

In Astana we often deal with situations where a young person has come from another region to study or work, lives alone in the Yesil or Baikonur district, and the parents learn about the problem over the phone. We consult relatives online, wherever they are, and arrange for a doctor to visit the address if needed. Our task is to relieve the acute condition and then help build long-term treatment and rehab.

Signs that loved ones notice

• sudden and unpredictable shifts in state: agitation followed by deep drowsiness
• the smell of alcohol combined with signs that ordinary drunkenness can’t explain
• things found at home: loose pills without packaging, syringes, small baggies, smoking blends
• frequent “food poisoning,” fainting, ambulance calls, and injuries of unknown origin
• debts, selling belongings, stealing from relatives, trouble with the law
• insomnia, anxiety, aggression, suspiciousness, thoughts of death
• rapidly declining health: weight loss, skin problems, frequent infections

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 move on to multiple substances

Polysubstance addiction often begins with a single substance, and others are added over time: to intensify the effect, to soften withdrawal, to fall asleep, or, on the contrary, to perk up. That is how alcohol gets combined with sleeping pills and stimulants with sedatives. Each new substance changes how the body tolerates the others, and the person loses any sense of how much is dangerous. This is precisely why the risk of overdose and respiratory depression is so high in polysubstance addiction.

Risk factors include starting to use at an early age, mental health conditions (depression, anxiety, ADHD, traumatic experiences), a social circle where people use, loneliness, and a lack of support. Many people who have moved to the capital from the regions find themselves without their usual circle of friends and slide into addiction without noticing. This is not a matter of weak willpower: addiction is a brain disorder described in ICD-10, and it is treated by doctors.

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 Astana

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

Where to get help

Narcology 24 in Astana: our duty team makes home visits day and night, usually within an hour (all city districts and nearby settlements). Two branches for appointments and procedures — 6 Auezova St., office 37, Astana and 176 Imanova St., Astana. When indicated, we arrange admission and transport.

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