Reviewed byRinat Zhumabekov, MDAddiction psychiatrist, experience 21 years · updated 8 Nov 2026
Key facts
- Who provides care
- a psychotherapist and a psychologist, plus a psychiatrist if a relative has anxiety or depression
- Where
- online by video call from anywhere in Zhezkazgan, or in-person appointments at the clinic
- Duration
- a consultation takes 60–90 minutes; a course of family therapy lasts from 2–3 months
- Anonymity
- confidential; information about your loved one and your family is protected by medical confidentiality
- When it is urgent
- threats, violence, overdose, or psychosis in a loved one — call 103 or 112
- Outcome
- less anxiety, clear boundaries, and constructive support for your loved one's treatment
What you should know
Definition. Codependency is not a diagnosis in ICD-10 or ICD-11; it is a concept from the practice of helping families that describes the state of people living alongside someone with alcohol, drug, or gambling addiction. Codependency is characterized by excessive control, attempts to “rescue” a loved one from the consequences of their use, neglect of one's own needs, chronic stress, and swings between hope and despair. Relatives themselves may develop anxiety and depressive disorders, as well as sleep problems.
The family is an important participant in addiction treatment. International guidelines, including NICE recommendations, state that involving loved ones increases the likelihood that a person will seek help and stay sober. That is why at Narcology 24, relatives can get a consultation even before the person agrees to treatment. Family support in Zhezkazgan is provided by a psychotherapist and a psychologist, and a psychiatrist joins if a relative has severe anxiety or depression. Most sessions are conveniently held online.
Signs of Codependency
- the family's mood and plans depend entirely on whether your loved one is sober
- you check their phone, pockets, and money, and call to find out where they are
- you make excuses for your loved one to their employer and relatives and pay off their debts
- you feel guilty for their substance use and believe you can stop them
- you have given up friends, hobbies, rest, and your own medical care
- you live in constant anxiety, sleep poorly, and get irritated over small things
- you alternate between threats, pleading, and promises, but nothing changes
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
The addiction of one family member creates chronic stress for everyone. To maintain some semblance of stability, loved ones take responsibility for that person's actions: they hide problems, settle conflicts, pay off debts, and call doctors. Over time, these actions become habitual, and their own needs fade into the background. Paradoxically, such care often shields the person from the consequences of their use and reduces their motivation to seek treatment.
Codependency is more likely in people who grew up in a family with addiction or rigid rules, who are used to caring for others, and who feel responsible for how others are doing. It is intensified by shame, fear of judgment, financial dependence on the loved one, and a lack of information about the illness. It is important to understand that codependency is not the relative's fault but a natural reaction to prolonged stress, and it can be worked on just like any other condition.
How Family Support Works
Step 1 — an initial consultation, most often online: the specialist learns about the situation in the family, the type of addiction, any risks to life, and the relatives' wishes. Step 2 — information: what addiction is, which treatment methods exist, and what to do in an emergency. Step 3 — a plan: how to talk to your loved one, which boundaries to set, and what to stop doing. Step 4 — individual or family psychotherapy, once the person with addiction is also ready for it.
Limitations. A consultation does not replace medical care for the person with addiction: a binge, withdrawal, or an overdose requires a doctor. If your loved one is making threats, being violent, is in a state of psychosis, or is unconscious — call 103 or 112. Involuntary treatment is possible only by court decision, in accordance with the procedure established by Kazakhstan law; the clinic does not use coercion. Teenagers from such families can get support from the 150 helpline.
How we help
Counseling for relatives
The first session helps reduce confusion. The specialist answers questions about the illness and explains which actions sustain the addiction and which ones help. The family receives a clear plan: what to do during a binge, a relapse, or threats; when to call an addiction doctor for a home visit and when to call an ambulance. A consultation can be arranged within 24 hours of contacting the clinic.
The CRAFT approach
Community Reinforcement and Family Training is a method of training loved ones whose effectiveness has been demonstrated in research. Relatives learn to reward sober behavior, allow the person to face the natural consequences of their use, communicate safely, and choose the right moment to suggest treatment. The approach leads to voluntary help-seeking more often than ultimatums do.
Family psychotherapy
When the person with addiction is in treatment, joint sessions help rebuild trust, divide responsibilities, and agree on rules. The psychotherapist works through accumulated resentments and conflicts and teaches family members to talk about feelings without blame. This reduces the risk of relapse and supports the whole family during recovery.
Individual therapy and support groups
It is important for relatives to restore their own lives: sleep, rest, interests, and social contact. Individual psychotherapy helps cope with anxiety, guilt, and burnout. Mutual support groups for the loved ones of people with addiction, based on the principles of the 12-step program, are also helpful. If a relative has depression or an anxiety disorder, it is treated.
Myths and facts
MythIf you love them enough and keep control, they will quit
FactAddiction is an illness, and control by the family does not remove its underlying mechanisms. On the contrary, excessive control often provokes resistance and hidden use. It is more effective to support treatment and set clear boundaries.
MythOnly the person who drinks or uses needs help
FactThe loved ones of people with addiction live under chronic stress and put their own health at risk. Helping the family is a goal in its own right. In addition, a change in relatives' behavior increases the likelihood that the person will agree to treatment.
MythNothing can be done until they want it themselves
FactMotivation can be shaped by a person's environment. Family-based methods such as CRAFT help loved ones create conditions in which the person is more likely to agree to treatment voluntarily.
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 Zhezkazgan
| 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
In zhezkazgan you can get help at home, at one of our two branches (104 Pushkina St., Zhezkazgan, 149 Alashakhana Ave., Zhezkazgan) or online if you need a consultation rather than a procedure. The dispatcher answers 24/7 and will tell you straight away which option is safest.
Confidential and private
in Zhezkazgan 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 seek help if the person does not want treatment?
Yes. A consultation for relatives is held regardless of whether your loved one agrees to treatment. The specialist will help you assess the risks, choose an approach, and prepare for the conversation. Changes in the family's behavior often become the first step toward the person seeking help themselves.
Can a person be forced into treatment?
Treatment at Narcology 24 is provided only on a voluntary basis. Involuntary treatment is possible only by court decision, in accordance with the procedure established by Kazakhstan law. Threats and deception usually make the situation worse. The specialist will help you find arguments that the person will be ready to hear.
How many sessions are needed?
Often just 1–3 consultations give relatives a clear plan of action. For lasting changes in the family, a course of family or individual therapy lasting 2–3 months or longer is recommended. The frequency of sessions is decided together with the specialist.
What should I do during a binge or a relapse?
Stay calm, do not argue, and remove any dangerous objects. If there is vomiting with blood, seizures, confusion, hallucinations, or chest pain — call 103 or 112. In other cases, you can call an addiction doctor for a home visit to assess the person's condition.
Should I pay off my loved one's debts?
Paying off debts unconditionally often relieves the person of responsibility and sustains the addiction. It is worth making this decision together with a specialist: sometimes it makes sense to help only as part of a treatment plan or on the condition that the person takes part in psychotherapy.
How can I support a child in such a family?
It is important to explain to the child in simple terms that addiction is an illness and that it is not their fault. Keep up the daily routine and usual activities. If the child shows anxiety, sleep problems, or difficulties at school, see a child psychologist. Children can call the 150 helpline.
Where do doctors visit in Zhezkazgan and where are the branches?
Home visits cover all city districts and nearby settlements, 24/7. Appointments at two branches: 104 Pushkina St., Zhezkazgan and 149 Alashakhana Ave., Zhezkazgan. Phone in Zhezkazgan: +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
