Polysubstance addiction in Yesik

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

Key facts

ICD-10 code

F19.2

Who provides care

an addiction doctor (narcologist) and a psychiatrist, followed by a psychotherapist, a psychologist, and a rehabilitation counselor

Where

detox mainly in an inpatient unit in Yesik, then on an outpatient basis or in a rehab program

Duration

detox takes 7–21 days; rehabilitation lasts from 3 months to a year

Anonymity

medical confidentiality and treatment with no entry in the state dispensary registry

When it is urgent

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

Outcome

giving up all substances, stable mental health, and restored physical health and social connections

What you should know

Definition. Polysubstance dependence (ICD-10 code F19.2, dependence syndrome due to multiple drug use) is diagnosed when a person regularly uses two or more substances and the signs of dependence relate to their combination. This may mean taking them at the same time, switching between substances without a “main” one, or using one substance to soften the effects of another. Alcohol combined with drugs also falls into this category.

Combined use increases the toxic effect of each substance and changes the clinical picture. Withdrawal consists of several syndromes at once, and their symptoms mask one another. That is why treatment of polysubstance dependence in Yesik almost always begins with observation in an inpatient unit, where a doctor can monitor breathing, blood pressure, consciousness, and mental state around the clock. At Narcology 24, the program is run jointly by an addiction doctor and a psychiatrist, and a psychotherapist and a rehabilitation specialist join later.

Signs of Polysubstance Dependence

• the person uses several substances or replaces one with another when it is unavailable
• some substances are used to boost or soften the effects of others
• alcohol is regularly combined with drugs or sedative medications
• the person's state changes sharply and unpredictably, from agitation to sluggishness
• there have been episodes of overdose, loss of consciousness, or calls for an ambulance
• anxiety, suspiciousness, hallucinations, or depression have appeared
• attempts to stop using one substance lead to increased use of another

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 Polysubstance Dependence Develops

Most often, polysubstance dependence develops gradually. A person addicted to one substance starts using another to cope with withdrawal, insomnia, anxiety, or a “comedown.” For example, stimulants are combined with sedatives or alcohol, and opioids with tranquilizers. Each substance reinforces the need for the other, creating a vicious circle that is difficult to break on your own.

Risk factors include starting to use at an early age, mental health disorders (depression, anxiety, PTSD, ADHD, personality disorders), traumatic experiences, a lack of support, and a social circle in which using several substances is common. The WHO notes that combined use is associated with the highest risk of fatal overdose — especially combining opioids with alcohol or sedatives, which together suppress breathing.

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 Yesik

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 Yesik: 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 — 125 Kamenskaya St., office 38, Yesik and 103 Zhambyla St., Yesik. 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