Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F10.2
- Who provides care
- An addiction medicine doctor, plus a psychotherapist if needed
- Format
- Online preparation and follow-up + in-person procedure
- Duration
- Consultation 30–40 minutes; the method’s effect lasts from several months to a year or more
- Anonymity
- No registry listing, medical confidentiality under Kazakhstan law
- When it’s urgent
- Drinking alcohol after coding, chest pain, shortness of breath — call 103 or 112
- Outcome
- Support for sobriety combined with psychotherapy
What you should know
“Coding” is an umbrella term for several approaches: medications that cause a severe reaction if alcohol is consumed, medications that reduce cravings, and psychotherapeutic suggestion techniques. What they have in common is that they create an external barrier that helps a person stay sober during the first, most vulnerable months. It is important to understand that coding does not change your personality or erase addiction — it buys time to build new habits.
Clinical guidelines consider medication support for sobriety only in combination with psychosocial treatment. That is why coding at Psychiatry Online starts with a video consultation: the doctor finds out how many days the person has been sober, what illnesses they have and whether there have been relapses, and explains the risks. The online format suits people who work in ministries and offices on the left bank and cannot take time off during the day — the conversation can take place in the evening without leaving home in windy weather.
Who Should Discuss Alcohol Coding With a Doctor
- repeated binges despite promises to yourself and your family to stop
- sobriety lasts a few weeks, and then drinking starts again
- you genuinely want to quit but need external support for your decision
- alcohol has already caused problems at work, in the family or with your health
- you have already had a period of sobriety and want to consolidate the result
- cravings appear in predictable situations: stress, weekends, holidays
- you are ready to stay sober for the required period before the procedure and undergo a medical workup
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 Coding Works — and Why It Doesn’t Work for Everyone
Aversive medications work by blocking the enzyme that breaks down acetaldehyde. If alcohol is consumed, acetaldehyde builds up and causes flushing, palpitations, nausea and a drop in blood pressure. Fear of this reaction becomes an external brake. Another group of medications acts on the brain’s opioid system and reduces the rewarding effect of alcohol: the person gets less pleasure from drinking, and cravings weaken.
Psychotherapeutic techniques rely on the power of expectations and beliefs. Their effect depends heavily on motivation: if a person comes under pressure from family, they are quicker to look for ways around the barrier. That is why coding works better when combined with work on triggers, support from loved ones and an action plan for moments of craving. Without this, the risk of relapse once the method’s effect ends remains high.
What Is Done Online When Preparing for Coding
During the video appointment, the addiction specialist takes a history: how long you have been drinking, the length of your most recent sobriety, chronic heart, liver or nervous system conditions and current medications. Have discharge summaries and lab results ready if you have them. The doctor explains the differences between methods, their expected effects and limitations, and checks that you understand the risks. The conversation takes place over a secure connection — you can join from your car in a parking lot or from home in Nura district; the main thing is that no one else is nearby.
The procedure itself cannot be performed online: an in-person examination, blood pressure measurement, and sometimes an ECG and lab tests are needed. Coding is not possible while intoxicated or immediately after a binge — a period of sobriety determined by the doctor is required. If you develop chest pain, shortness of breath or a reaction after drinking alcohol, call 103 or 112.
How we help
Aversive Pharmacotherapy
Medications that block acetaldehyde metabolism create a pronounced unpleasant reaction to alcohol. This method requires careful patient selection: it is contraindicated in a number of heart, liver and mental health conditions. The patient is fully informed about the consequences of drinking, and the procedure is carried out only with written consent and after confirmed sobriety.
Craving-Reducing Medications
Opioid receptor antagonists and other medications reduce the pleasure from alcohol and the intensity of cravings. International guidelines describe them as part of standard addiction treatment. Their effect is milder than that of aversive methods, but they carry fewer risks and are easier to combine with psychotherapy and online monitoring.
Psychotherapeutic Coding
Suggestion-based and stress-psychotherapy techniques rely on a commitment to sobriety that is formed during the session. They do not involve medications, so they are suitable for people for whom pharmacotherapy is contraindicated. Effectiveness depends on the person’s readiness, so a motivational conversation — often online — is held before the session.
Support After the Procedure
The most vulnerable period is the first few months. Regular video meetings with a doctor or psychotherapist help track cravings, work through high-risk situations and adjust the plan. Dark winter evenings and short daylight hours intensify low mood and the urge to unwind, so during this time sessions can be scheduled more often and kept shorter.
Myths and facts
MythCoding is just scaring people — it doesn’t work
FactMethods differ. Pharmacological approaches have a clear biochemical mechanism, while psychotherapeutic ones rely on beliefs and motivation. No method works in isolation, but as part of comprehensive treatment, coding helps people stay sober during the first months.
MythA person can be coded without their knowledge
FactNo. Coding is carried out only with voluntary informed consent, while sober and after a medical workup. Secretly giving someone medication is life-threatening and against the law. If your loved one is not ready, start with a consultation for family members.
MythAfter coding, addiction is gone forever
FactCoding does not remove addiction; it creates a period of sobriety during which new skills need to be built. Once the method’s effect ends, cravings may return if no psychotherapeutic work has been done and lifestyle has not changed.
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 consultation before coding | free |
| Assessment and coding procedure | 55 000 ₸ |
| Online therapist support (4 sessions) | 50 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
Psychiatry Online in Astana: same-day video appointments and two branches for in-person visits — 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Our mobile team works around the clock: all city districts and nearby settlements. If you live elsewhere in Astana and Akmola Region, starting online is usually easiest.
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 long do I need to stay sober before coding?
It depends on the method and your health, and the doctor determines it after the consultation. Pharmacological methods require confirmed sobriety — sometimes several days or longer. During the video appointment, the addiction specialist explains what period you specifically need and helps you get through it safely.
Can I choose a method online?
Preliminarily, yes: the doctor takes your history, explains the pros and limitations of each approach and considers contraindications. The final decision is made after an in-person examination and tests. This saves time: you arrive at your in-person appointment already understanding what to expect.
What happens if I drink after coding?
With aversive methods, a severe reaction is possible: flushing, palpitations, nausea, a drop in blood pressure and, in dangerous cases, heart rhythm disturbances. If these symptoms appear, call 103 or 112. With craving-reducing methods there is no such reaction, but the effect of treatment is reduced.
Will my workplace find out about the coding?
No. Your visit is anonymous, and the information is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System.” For civil servants who worry about their reputation, confidentiality is a key consideration. Disclosure is possible only in cases provided for by law.
Do I need psychotherapy if I’ve been coded?
Yes, it is recommended. Coding provides a pause, while psychotherapy helps you understand why cravings arise and learn to cope with stress and boredom without alcohol. Online sessions are convenient in the evening, with no trips across the city in frost and wind.
Can a relative be coded at their request if they live far away?
Preparation and consultation can be done online if the person contacts the doctor themselves and gives consent. The procedure is performed in person, so a visit to the clinic or to a doctor in their city will be required. The decision always remains with the patient.
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
