Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- Who provides care
- a psychotherapist; a narcologist and a psychiatrist join when indicated
- Format
- regular video sessions, messaging with a care coordinator, unscheduled contact when cravings are strong
- Duration
- 50-minute sessions; the program usually lasts 3 to 6 months, followed by maintenance sessions
- Confidentiality
- no registration and no full name required; medical confidentiality under the laws of the Republic of Kazakhstan
- When it's an emergency
- severe withdrawal after a relapse, overdose, suicidal thoughts — call 103, 112 or 150
- Outcome
- a personal relapse prevention plan, skills for managing cravings and a quick return to sobriety after slip-ups
What you should know
The first months after coming off a binge, being “coded” or finishing rehab are a time when a person is especially vulnerable. Everything around them is the same as before: the same route home from work past a familiar bar, the same friends, the same tois (large family celebrations) with endless toasts. Here is how getting support works with us: you write on WhatsApp, “I've been holding on for three weeks, but it's getting hard,” a psychotherapist joins a video call, and together you work out what exactly is pushing you toward using right now and how to deal with it.
In Almaty, where the workday ends late and the drive from the center to Nauryzbay district or Kaskelen can take more than an hour, it is hard to travel to weekly support sessions, and people give up. The online format removes that obstacle: a session lasts 50 minutes and can be done from home or from your car. Psychiatry Online brings a psychotherapist, a narcologist and, if needed, a psychiatrist together as one team so that a relapse, if it happens, does not turn into a binge lasting several days.
Warning Signs That Your Relapse Risk Is Rising
- you more and more often remember “how good it felt” after drinking or using
- the thought has crept in that “one drink” or “one bet” won't change anything
- you have stopped keeping your commitments: skipping sessions, not calling your care coordinator
- fatigue, irritability, insomnia or a sense of emptiness are building up
- you are once again spending time with people and in places associated with using
- something stressful has happened: a conflict, job loss, divorce, a loved one's illness
- you have started hiding thoughts about cravings from loved ones and avoiding conversations about sobriety
If heavy drinking has lasted more than two or three days, or there is shaking, vomiting, blood-pressure spikes or insomnia, you need a doctor rather than stopping alone. An online consultation is free and helps assess the risks before a visit. For seizures, confusion or hallucinations call 103 or 112.
Why Relapses Happen and How to Prevent Them
Addiction is a chronic condition in which relapse is possible, and this does not mean treatment is useless. The brain needs time to rewire its responses to familiar cues: a place, a time of day, a mood, certain people. A relapse is usually set up in advance — first through an emotional stage (tension, fatigue, isolation), then a mental stage (memories, bargaining with yourself), and only after that does the actual use happen.
Relapse prevention, developed within the cognitive behavioral approach, teaches you to notice these stages and step in as early as possible. International guidelines emphasize the importance of long-term support: regular sessions, treatment of co-occurring anxiety and depression, and restoring sleep, relationships and a sense of meaning. When indicated, a doctor may recommend medications that reduce cravings — but only after a medical evaluation.
How Online Relapse Prevention Works
Sessions take place on WhatsApp, Telegram or Zoom at the same time each week — regularity in itself is supportive. Together with you, the psychotherapist maps out your personal triggers and early warning signs, a plan for “what I do when a craving hits,” and a list of people you can call. You discuss the past week, difficult situations and small wins. Between sessions, you can send a short message to your care coordinator if things get hard.
If a relapse has turned into a binge with marked withdrawal, online support is not enough — a narcologist's home visit or a hospital stay is needed. If there are seizures, hallucinations or a suspected overdose, call 103 or 112. If suicidal thoughts appear, tell your specialist and your loved ones and call 103, 112 or the 150 helpline. Medications can be prescribed within the requirements of Kazakhstan law.
How we help
A personal relapse prevention plan
A written plan is something to lean on at a moment when it is hard to think. It lists your triggers, early warning signs, specific actions to take when a craving comes, support contacts and what to do if you relapse. The plan is drawn up in the first sessions and regularly updated to account for new situations — a new job, a move, holidays.
Cognitive behavioral techniques
You learn to notice automatic thoughts such as “I deserve to unwind,” test them against reality, shift your attention and “ride out the wave” of a craving. You practice refusal skills for social settings, work and family celebrations. These skills are rehearsed in sessions and reinforced in everyday life between them.
Managing stress and co-occurring conditions
Chronic stress, anxiety, depression and insomnia are common causes of relapse. The psychotherapist helps you master self-regulation techniques, and a psychiatrist assesses your condition and discusses treatment if needed. An important part is restoring a healthy routine: sleep, nutrition, physical activity and rest without alcohol. This makes you less vulnerable.
A rapid response to relapse
If you have had a drink or used, the most important thing is not to hide it and not to wait. Message your care coordinator, and a specialist will get in touch shortly: they will assess your condition, help you stop and arrange a narcologist's home visit if needed. Then, without blame, you work out together what led to the relapse and adjust the plan.
Myths and facts
MythA relapse means treatment didn't work
FactRelapses occur in many chronic diseases, and addiction is no exception. A relapse is a signal that the plan needs adjusting, not a reason to give up. Getting back to sobriety quickly is also a result of treatment.
MythAfter a year without alcohol, you no longer need support
FactThe risk decreases over time but never disappears completely. Many people benefit from keeping occasional maintenance sessions, especially during periods of stress and change. The frequency of sessions can be reduced gradually, together with your specialist.
MythCravings can only be overcome by willpower
FactWillpower gets depleted, especially when you are tired or stressed. Skills, an action plan, support from other people and, when indicated, medical care work more reliably. Online support helps you build that system.
How an online appointment works
- Message or callWrite on WhatsApp or call — our coordinator replies within minutes, day or night. You don't have to give your surname.
- Doctor and timeWe match you with a psychiatrist, addiction specialist or psychotherapist and agree on a time — often the same day.
- Video consultationA secure 50–60 minute video call: the doctor takes a detailed history and uses standardised scales if needed.
- Treatment planYou receive a clear summary, recommendations and a plan: what we do online and what needs an in-person visit or home call.
- Follow-upOnline follow-up sessions, messenger contact with your doctor, and treatment adjustments until you get a stable result.
Prices in Almaty
| Online addiction specialist consultation | 12 000 ₸ |
| Online addiction therapy session | 15 000 ₸ |
| Online support program (one month) | 80 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
An online consultation for “Relapse prevention online” is available to people across Almaty and Almaty Region 24/7 — from home, work or while travelling. For an in-person visit, Psychiatry Online in Almaty has two branches: 129 Kurmangazy St., office 8, Almaty and 110 Bogenbay batyra St., office 15, Almaty. Doctor home visits: all city districts and nearby settlements.
Confidential and private
An online appointment in Almaty is first of all about privacy: no clinic visit, no waiting room. A private room and headphones are enough. Data is stored in a secure system with restricted access and does not enter any state registry without legal grounds.
Questions and answers
How often should I have relapse prevention sessions?
In the first months of sobriety, usually once a week, then once every two weeks and less often after that. The frequency depends on how long you have been in remission, your stress load and how you feel. The online format means you don't have to miss sessions even if you are on a business trip or live outside the city.
Can I contact a specialist if a craving hits at night?
Yes, we are available around the clock: message us on WhatsApp and the specialist on duty will reply. Cravings are often especially strong at night, so your plan spells out in advance what to do in that case. If you have alarming symptoms, call 103 or 112.
Is the program suitable after a rehabilitation center?
Yes, this is one of the most important moments. After discharge, a person returns to their usual environment, and support helps transfer the skills learned in the center into everyday life in Almaty. We can coordinate the plan with the recommendations of the rehabilitation program.
What should I do if I've already relapsed?
Don't face it alone. Message your care coordinator and honestly tell them what happened. The specialist will assess your condition, arrange a narcologist's home visit if needed, and then you will work through the causes together. Feeling guilty is natural, but it shouldn't stop you from getting back to your plan.
Can relapse prevention be combined with coding?
Yes, it's a good combination. Coding creates an external barrier, while psychotherapy helps you deal with the reasons behind your substance use and prepare for the moment when the coding period ends. The narcologist and psychotherapist work in coordination.
Do relatives take part in the program?
If you wish. Loved ones can attend certain sessions to understand your plan and learn how to support you without pressure or control. They can also have their own consultations if they need help coping with anxiety.
Where can I be seen in Almaty?
Online — from anywhere in the city or region. In person — at two branches: 129 Kurmangazy St., office 8, Almaty and 110 Bogenbay batyra St., office 15, Almaty. Both are open 24/7; home visits cover all city districts and nearby settlements.
Sources and methodology
This page was prepared by the Psychiatry Online 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) and APA (US) guidelines on the treatment of mental disorders
- WHO recommendations on telemedicine and digital health
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
