Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- Who leads care
- A psychiatrist specializing in addiction medicine on duty
- Format
- Urgent video or phone call, followed by a home visit or hospital
- Duration
- Response usually within an hour, consultation 20–40 minutes
- Anonymity
- Medical confidentiality under Kazakhstan law; full name not required
- When it's urgent
- Seizures, loss of consciousness, hallucinations, chest pain — call 103 or 112 at once
- Outcome
- A decision for the next few hours: stay home, a doctor's visit or an ambulance
What you should know
Why do alcohol problems seem especially frightening at night? Withdrawal often gets worse in the evening and at night: blood alcohol levels fall, anxiety, a racing heart and insomnia increase, and sometimes hallucinations and seizures appear. This is exactly when families are left without support — outpatient clinics are closed, and people are afraid to call an ambulance. Clinical guidelines stress that a timely assessment of withdrawal severity prevents dangerous complications, including delirium.
A 24/7 online addiction specialist gives you the chance to get professional advice at three in the morning without leaving home. If you live in Nura or Baikonur district, a blizzard is raging outside and the nearest clinic is far away, a video call helps you quickly understand whether it is safe to stay at home or whether a doctor's visit or an ambulance is needed. An addiction specialist at Psychiatry Online talks with the person themselves or with relatives if the patient is unable to talk.
When to call the addiction specialist on duty
- a drinking binge has lasted several days and you can't stop on your own
- severe shaking, sweating and a racing heart after stopping drinking
- insomnia, fear, anxiety, a feeling of impending doom
- unable to eat or keep water down, constant vomiting
- a relapse after a long period of sobriety, confusion, shame
- an intoxicated loved one is aggressive or behaving strangely
- suspected mixing of alcohol with medications or drugs
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 alcohol withdrawal can be dangerous
With long-term use, alcohol constantly suppresses the nervous system, and the brain compensates by ramping up excitatory processes. When alcohol is stopped abruptly, the brakes disappear but the excitation remains: hence shaking, anxiety, a racing heart and insomnia. In severe cases, seizures and alcohol withdrawal delirium (delirium tremens) develop — an emergency that requires medical care. The longer the binge, the higher the risks.
Severity is influenced by age, chronic liver and heart disease, previous episodes of severe withdrawal and other medications being taken. The situation often gets worse at night and on weekends, when no one is keeping an eye on the person. Short daylight hours and the long winter increase the tendency toward prolonged drinking, while a demanding work schedule makes people put off getting help “until vacation.” That is why round-the-clock assessment is especially important.
How a 24/7 online consultation works
You call or submit a request, and the addiction specialist on duty joins a video call. If the patient is able to talk, the doctor speaks with them; if not, with the relatives. The questions cover how long the person has been drinking, symptoms, chronic illnesses, medications and any history of seizures. Show the patient on camera if possible. Have the packaging of any medications taken at hand. The result is a clear plan for the next few hours.
An IV drip, detox and assessment based on lab tests cannot be done online. In case of seizures, loss of consciousness, hallucinations, chest pain or a suspected overdose, call 103 or 112 immediately. For a prolonged binge, the doctor arranges a home visit or hospitalization. Alcohol “coding” (a treatment widely used in Kazakhstan and CIS countries) is carried out only in person, after an examination and sobriety, with consent and as part of comprehensive treatment.
How we help
Urgent severity assessment
The addiction specialist on duty uses structured criteria for assessing withdrawal: tremor, sweating, anxiety, perceptual disturbances and orientation. They identify risk factors — the length of the binge, previous seizures and delirium, heart and liver disease. On this basis, it is decided whether it is safe to stay at home until morning.
Arranging a doctor's home visit
If the condition requires medical care but does not pose an immediate threat to life, the doctor on duty arranges for an addiction specialist to visit the home. There, an in-person examination is carried out and, if indicated, IV fluid therapy is given. Home visits are available to different parts of the city, but in blizzards and icy conditions arrival time may be longer — the doctor will warn you in advance.
Referral to hospital
When the risk of complications is high — previous seizures, serious co-existing illnesses, signs of delirium — inpatient care with constant monitoring is recommended. The addiction specialist explains how to prepare the patient and which documents to take, and helps arrange voluntary admission without unnecessary delays or stress for the patient.
Ongoing care
After the acute state has passed, it is important not to stop: without treatment for addiction, binges recur. The addiction specialist proposes a plan — psychotherapy, medication support and family work. Follow-up consultations are held online at a convenient time, which increases the chances of seeing treatment through to a lasting result.
Myths and facts
MythA hangover can be cured with another drink
FactThe “hair of the dog” temporarily relieves symptoms but prolongs the binge and makes withdrawal worse later on. This is a key mechanism in the development of addiction. It is safer to get a professional assessment.
MythYou can't reach an addiction specialist at night
FactThe 24/7 online service was created precisely for nighttime and weekend situations. The doctor on duty is available at any time, including public holidays. If life is in danger, always call 103 or 112.
MythIf the person has fallen asleep, everything is fine
FactDeep sleep during heavy intoxication may actually be loss of consciousness. There is a risk of choking on vomit and of breathing stopping. Lay the person on their side, monitor their breathing and, if in doubt, call 103 or 112.
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 Astana
| Online addiction specialist consultation | 12 000 ₸ |
| Online consultation for relatives | 12 000 ₸ |
| Addiction specialist home visit | 40 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
You can book in Astana online or at one of two branches: 72 Bogenbay batyra St., Astana, 37 Petrova St., office 23, Astana. Our coordinator replies on WhatsApp within minutes at any time, and a doctor usually connects by video the same day; home visits are available too — all city districts and nearby settlements.
Confidential and private
Information about your visit, diagnosis and treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. We never share it with your employer, school or relatives without your consent; the only exceptions are those expressly set out by law. For an online consultation your first name is enough, video runs over a secure channel and nothing is recorded without your consent.
Questions and answers
How quickly does the addiction specialist on duty respond?
Usually within an hour, around the clock and seven days a week. At night and on holidays demand is higher, but emergency requests are handled first. If you cannot wait and life is in danger, call 103 or 112 right away.
Can we get help if the patient refuses?
Relatives can get advice themselves: the doctor will explain how to ensure safety and how to talk to the person. Treatment is provided only with the patient's consent, except in cases expressly provided for by the law of the Republic of Kazakhstan. If life is in danger — 103 or 112.
What should we do until the doctor arrives?
Don't leave the person alone; lay them on their side if they are drowsy, and give them water in small sips. Don't give sleeping pills or sedatives unless prescribed. Remove the alcohol. If seizures, confusion or chest pain appear, call 103 or 112.
Will the information be passed on to my employer?
No. Information about your visit is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System.” Your employer will not find out about the consultation. The only exceptions are cases established by law. You can seek help without giving your full name.
Can I get “coded” at night?
No. Coding is carried out only in person, after an examination, with confirmed sobriety and written consent, as part of comprehensive treatment. In an acute state, the person first needs to be brought out of the binge and stabilized. The addiction specialist will explain how to prepare.
How much does a night consultation cost?
The cost depends on the format: an online consultation, a doctor's home visit or hospitalization. Check current prices with the Psychiatry Online administrator when you get in touch. Before providing care, the doctor will explain what the service includes, with no hidden charges or unnecessary procedures.
Where can I be seen in Astana?
Online — from anywhere in the city or region. In person — at two branches: 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. 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
