Reviewed byNurlan Isayev, MDAddiction psychiatrist, experience 10 years · updated 8 Nov 2026
Key facts
- Who provides care
- an addiction doctor (narcologist) together with a psychiatrist, and with a relevant specialist in cases of chronic pain
- Where
- on an outpatient basis, at home in Rudny under supervision, or in an inpatient unit — the choice depends on the medication and the dose
- Duration
- gradual tapering takes from 2 to 8 weeks or longer, followed by 3–6 months of psychotherapy
- Anonymity
- treatment is provided on a paid, anonymous basis, with no entry in the state dispensary registry
- When it is urgent
- seizures, confusion, hallucinations, or slowed breathing — call 103 or 112
- Outcome
- safely stopping the medication, normal sleep, and control of anxiety without dependence
What you should know
Definition. Prescription drug dependence is a dependence syndrome that develops while taking medications with psychoactive effects. In ICD-10, it is coded by substance group: sedatives and hypnotics — F13.2, opioids — F11.2, stimulants — F15.2. Dependence can develop even when a medication is taken as prescribed if the course has gone on too long or the dose has been increased without a doctor's supervision. Having a prescription does not rule out the diagnosis.
The main feature of this type of dependence is dangerous withdrawal. Abruptly stopping benzodiazepines or barbiturates can cause seizures and delirium, while opioid withdrawal is accompanied by severe pain and autonomic symptoms. That is why treatment of prescription drug dependence in Rudny always begins with an in-person examination and an individual dose-reduction schedule. Narcology 24 specialists also assess the original reason for taking the medication — pain, insomnia, or anxiety — in order to prescribe a safe alternative.
Signs of Prescription Drug Dependence
- the medication is taken for longer than prescribed or in higher doses
- the usual dose no longer works, and there is an urge to increase it
- without the pill, anxiety, tremors, insomnia, sweating, or pain appear
- the person visits different doctors or pharmacies to get a prescription
- thoughts about whether there will be enough of the medication take up a large part of the day
- daytime drowsiness, slowed speech, and memory lapses have appeared
- attempts to give up the medication end with a return to taking it
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 Prescription Drug Dependence Develops
Sleeping pills, tranquilizers, and opioid painkillers act on the brain systems responsible for inhibition, relaxation, and pain perception. With long-term use, the brain adapts: receptors become less sensitive, and a higher dose is needed to achieve the same effect. When the dose is reduced, a rebound reaction occurs — anxiety, insomnia, and pain become stronger than they were before treatment started. This reinforces the habit of taking the medication.
Risk factors include a long course without a review of the prescription, increasing the dose on your own, combining the medication with alcohol, chronic pain, anxiety disorders and insomnia, and a previous history of addiction. International guidelines, including NICE recommendations, state that benzodiazepines for insomnia and anxiety should be prescribed only in short courses. A person often does not notice the transition from treatment to dependence and seeks help only once the symptoms have become pronounced.
How Treatment Works: From Examination to Tapering
Step 1 — an online or in-person consultation: the doctor finds out the name of the medication, the dose, how long it has been taken, whether it is combined with alcohol or other substances, and why it was prescribed. Step 2 — an examination with a check of blood pressure, pulse, and neurological status, plus lab tests if needed. Step 3 — a schedule for gradual dose reduction, sometimes with a switch to a longer-acting medication. Step 4 — regular monitoring of how the patient feels, alongside psychotherapy.
Contraindications to tapering at home: high doses, taking several sedatives at once, combined use with alcohol or opioids, a history of seizures, severe heart, liver, or lung disease, old age with cognitive impairment, and suicidal thoughts. In these cases, tapering is carried out in an inpatient unit. In case of seizures, slowed breathing, or loss of consciousness, call 103 or 112 immediately.
How we help
Gradual tapering of the medication
Stopping a medication abruptly is dangerous, so the dose is reduced step by step at intervals chosen individually. The pace depends on how the patient feels and can be slowed down. For dependence on short-acting drugs, the doctor may switch the patient to a longer-acting medication from the same group so that withdrawal is milder. All changes are agreed upon with the patient.
Symptomatic treatment
During tapering, anxiety, insomnia, muscle tension, and pain may increase. To relieve them, the doctor selects medications from other groups that carry no risk of dependence, B vitamins, and, if needed, liver-protecting drugs and IV detox solutions. Opioid painkillers and sedatives are prescribed only by a doctor and only when strictly indicated.
Cognitive behavioral therapy for insomnia and anxiety
Many people start taking sleeping pills because of sleep problems. According to international guidelines, CBT for insomnia (CBT-I) is a first-line treatment: sleep routine rules, work with thoughts about sleep, and relaxation techniques. For anxiety disorders, psychotherapy helps manage symptoms without pills. The course can be held in person or online.
Managing chronic pain
If dependence developed while taking painkillers, it is important not to leave the patient without help for their pain. The addiction doctor works with a neurologist or another relevant specialist to select non-drug methods and medications without a risk of dependence. Psychotherapy helps reduce the impact of pain on everyday life.
Myths and facts
MythIf a doctor prescribed the medication, there can be no dependence
FactDependence develops whether or not there is a prescription. The risk grows with long-term use, increasing doses, and combining the medication with alcohol. That is why prescriptions for sedatives and opioids should be reviewed regularly.
MythIt is better to quit all at once than to suffer for a long time
FactAbruptly stopping benzodiazepines or barbiturates can cause life-threatening seizures and delirium. The safe approach is a gradual dose reduction under a doctor's supervision, even if it takes several weeks.
MythInsomnia cannot be treated without pills
FactCognitive behavioral therapy for insomnia is recognized as a first-line treatment and gives lasting results without any risk of dependence. Medications can be used in a short course, but they are not the only way to restore healthy sleep.
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 Rudny
| Initial addiction doctor consultation | 9 500 ₸ |
| Inpatient detox (per day) | 28 000 ₸ |
| Psychotherapy course (8 sessions) | 77 000 ₸ |
| 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
Narcology 24 in Rudny: 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 — 101 Pushkina St., Rudny and 30 50 let Oktyabrya St., Rudny. 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
Can I stop taking sleeping pills on my own?
This is not recommended. After long-term use, stopping abruptly can cause anxiety, insomnia, and tremors, and with some medications, seizures. It is safer to discuss a dose-reduction plan with a doctor, who will take into account the medication, the dose, how long you have been taking it, and any co-existing conditions.
How long does tranquilizer withdrawal take?
The timing is individual. With low doses and short-term use, tapering may take 2–4 weeks; after long-term use of high doses, it may take several months. What matters is not speed but safety: the pace of reduction is adjusted according to how the patient feels.
What does opioid painkiller withdrawal look like?
Symptoms include muscle and joint pain, sweating, a runny nose, chills, nausea, diarrhea, restlessness, and insomnia. The condition is hard to endure, but with proper medical care it becomes manageable. The addiction doctor decides on the approach after an examination; if other substances are also involved, inpatient care is preferable.
Will my regular doctor or employer find out?
No, unless you give your own consent. Contacting Narcology 24 is anonymous, and the information is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System.” Exceptions are allowed only in cases expressly provided for by law.
What can be done online?
By video call, the doctor carries out an initial assessment, clarifies the medications and doses, explains treatment options, and answers relatives' questions. Online sessions are also convenient for psychotherapy and for monitoring during gradual tapering. An examination and inpatient tapering require an in-person visit.
What should I do about pain or insomnia after stopping the medication?
The doctor selects alternatives with no risk of dependence: medications from other groups, physical methods, CBT for insomnia, and psychotherapy for anxiety. For chronic pain, a relevant specialist is brought in. The goal is to make sure the person is not left alone with the original problem.
Where do doctors visit in Rudny and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 101 Pushkina St., Rudny and 30 50 let Oktyabrya St., Rudny. Phone in Rudny: +7 (700) 309-30-65.
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

