Reviewed byNurlan Isayev, MDAddiction psychiatrist, experience 10 years · updated 8 Nov 2026
Key facts
- Who provides care
- a psychotherapist, an addiction doctor (narcologist), and a psychiatrist for co-occurring disorders
- Where
- on an outpatient basis at the clinic in Zhanaozen or online by video call
- Duration
- the active course includes 8–16 sessions, with support for 3 to 12 months
- Anonymity
- confidential, with no registry entry, protected by medical confidentiality
- When it is urgent
- a severe drinking binge, seizures, psychosis, overdose, or suicidal thoughts — 103 or 112
- Outcome
- the ability to recognize the threat of relapse and stop before using
What you should know
Definition. A relapse is a return to using a psychoactive substance or to gambling after a period of sobriety. A distinction is made between a single episode of use (a lapse) and a full relapse with a return to the old pattern. A relapse does not begin suddenly: it is usually preceded by emotional changes, then mental preparation, and only then by actual use. Relapse prevention is a structured method that teaches people to notice these stages and intervene as early as possible.
The relapse prevention model, developed within the cognitive behavioral approach, is part of international recommendations for addiction treatment. It is used for alcohol, drug, gambling, and nicotine addiction. Relapse prevention in Zhanaozen at Narcology 24 includes work with a psychotherapist, medical monitoring, and, when indicated, relapse prevention medication. Sessions take place in person or online, which makes it possible to keep them regular even with a busy schedule.
Early Warning Signs of Relapse
- irritability, anxiety, and fatigue grow, and sleep becomes disrupted
- the person stops going to meetings and skips psychotherapy
- thoughts like “just once won't hurt” or “I'm in control now” appear
- contact with old friends who use resumes
- the person hides their feelings, isolates themselves, and avoids talking about sobriety
- they recall pleasant episodes of use more often and check where they could get the substance
- unjustified tension over money, work, or relationships appears
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 Relapses Happen
Addiction is a chronic condition, and the risk of relapse persists long after use has stopped. The brain retains traces of the link between the substance or gambling and a feeling of relief. Stress, fatigue, conflicts, holidays, and encounters with familiar places and people activate these links and trigger cravings. The risk is highest in the first 3–6 months, but the threat can arise even years later.
The relapse prevention model identifies high-risk situations: negative emotions (anger, sadness, anxiety), interpersonal conflicts, social pressure, and also positive events when a person wants to “celebrate.” Cognitive traps also lead to relapse: the abstinence violation effect (“I've already had a drink, so it doesn't matter anymore”), overconfidence, and denial of the problem. Knowing your personal triggers and having a plan prepared in advance makes relapse manageable.
How the Relapse Prevention Program Works
Step 1 — a consultation: an assessment of the current condition, the length of sobriety, and previous relapses and their causes. Step 2 — mapping out personal high-risk situations and early warning signals. Step 3 — a written action plan: whom to call, what to do, and what to tell yourself when cravings hit. Step 4 — practicing skills for saying no, managing stress, and solving problems. Step 5 — regular check-in sessions. Most sessions can be held online.
Limitations. The program is designed for people who have already stopped using. If a drinking binge or drug use has started, medical help is needed first: a home visit by an addiction doctor or inpatient care. Relapse prevention medication is prescribed only after an examination and in the absence of contraindications. In case of delirium, seizures, loss of consciousness, signs of overdose, or suicidal thoughts, call 103 or 112.
How we help
Cognitive behavioral relapse prevention
The psychotherapist helps identify personal triggers, analyze previous relapses, and prepare specific strategies for each situation. The patient learns to notice thoughts that justify using and replace them with realistic ones. The method includes skills training: turning down offers, managing anger and sadness, and solving problems. The course consists of 8–16 sessions.
Mindfulness-based relapse prevention
Mindfulness methods teach a person to observe a craving without acting on it: notice the urge, name it, and wait until it weakens. Research describes this approach as an effective addition to CBT. The exercises are short and can be done in any setting. Sessions are held individually or in a group, including online.
Relapse prevention medication
When indicated, the addiction doctor prescribes medications that reduce cravings — for example, opioid receptor antagonists for alcohol and opioid addiction — or medications to correct sleep and mood. Blockers, alcohol “coding” (a treatment widely used in Kazakhstan and CIS countries), and chemical protection are possible only after an examination, the required period of sobriety, and written informed consent, as part of a comprehensive approach.
Support from family and social circle
Loved ones learn to notice early signals and respond without blame: offer to talk, remind the person of the plan, and help them contact a doctor. House rules, keeping alcohol off the table at family celebrations, and ways to spend time without using are discussed. A supportive environment is one of the strongest protective factors.
Myths and facts
MythA relapse means the treatment has failed
FactRelapses are a common part of the course of chronic diseases, including addiction. What matters is how quickly the person returns to sobriety and what conclusions they draw. Analyzing the relapse with a psychotherapist helps strengthen the plan.
MythIf you have held out for a year, the risk is gone
FactThe risk decreases over time but does not disappear completely. Stress, loss, and life changes can trigger cravings even years later. That is why it is useful to keep practicing relapse prevention skills on an ongoing basis.
MythWillpower is enough
FactWillpower runs out with fatigue and stress. A plan prepared in advance, support from those around you, and skills practiced in psychotherapy are more reliable. They work even when you have little strength left.
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 Zhanaozen
| Rehab programme consultation | 9 500 ₸ |
| Outpatient programme (one month) | 120 000 ₸ |
| Residential rehab (one month) | 320 000 ₸ |
| 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
“Relapse prevention” in Zhanaozen is available 24/7, including weekends. Home visits: all city districts and nearby settlements. For appointments, Narcology 24 has two branches: Building 6, Kurkemes Microdistrict, Zhanaozen and Building 47, Astana Microdistrict, Zhanaozen. If you live elsewhere in Mangystau Region, call us and we'll advise the fastest way to get help.
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
When should relapse prevention start?
Ideally right after detox or alongside rehab. The risk of relapse is highest in the first months of sobriety, so the skills need to be developed in advance. However, you can start at any stage, including after a relapse has already happened.
What should I do if a relapse has already happened?
Stop using as early as possible and contact your doctor or psychotherapist. If the condition is severe, call an addiction doctor for a home visit or call 103 or 112. Once you are stable, work through with a specialist what led to the relapse and adjust the plan.
Does “coding” help prevent relapse?
“Coding” and chemical protection can be part of comprehensive treatment, but they do not replace psychotherapy. They are carried out only after an examination, the required period of sobriety, and written consent. Without addressing the reasons for use, the risk of relapse remains once the “coding” period ends.
Can I take the program online?
Yes, the psychotherapy part of relapse prevention is well suited to the online format. An in-person appointment is needed to prescribe and monitor relapse prevention medication if an examination or lab tests are required, and also if the condition worsens.
How long does the program last?
The active course usually includes 8–16 sessions. After that, maintenance sessions every 2–4 weeks are recommended for 3–12 months. The length depends on the type of addiction, the length of sobriety, the number of previous relapses, and the presence of co-occurring disorders such as depression or anxiety.
How can the family help?
Loved ones can know the relapse prevention plan, notice early warning signs, and respond calmly. Narcology 24 specialists hold consultations for relatives, including online, and explain how to support sobriety without control or blame.
Where do doctors visit in Zhanaozen and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: Building 6, Kurkemes Microdistrict, Zhanaozen and Building 47, Astana Microdistrict, Zhanaozen. Phone in Zhanaozen: +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
