Reviewed byBaurzhan Kassymov, MDAddiction physician · updated 11.11.2026
Key facts
- ICD-10 code
- F10.2
- Who provides it
- an addiction physician; the drug is administered in the clinic's treatment room
- Where
- clinics in Almaty and Astana; online initial consultations for all of Kazakhstan
- Duration
- examination and procedure take 1–2 hours; the effect lasts from months to a year
- Confidentiality
- no registration with the state addiction (dispensary) registry; medical confidentiality under the Code of the Republic of Kazakhstan
- When it is an emergency
- flushing, choking, chest pain or a drop in blood pressure after drinking — call 103 or 112
- Outcome
- reduced cravings or a lasting break from alcohol for the agreed period
What to know
When a patient chooses medication-based alcohol “coding” (a treatment widely used in Kazakhstan and CIS countries), the key thing to understand is that the drug does not “switch off” the desire to drink and does not change a person's character. It works either as a chemical barrier or as a means of weakening cravings. In the first case, drinking alcohol causes a severe reaction — the person knows this, and that knowledge holds them back. In the second case, alcohol simply stops giving the same pleasure, and cravings gradually decrease.
I explain to every patient in detail which drug we plan to use, how it works, how long the effect lasts, what sensations are possible after it is given and what will happen if sobriety is broken. There should be no “secrecy” here: informed consent is signed only after the person has understood all the conditions. If anything remains unclear, it is better to ask the question twice than to face an unexpected reaction.
Who May Benefit from Medication-Based Coding
- the person consciously wants to stop drinking and agrees to medication support
- a clear “barrier” is needed for a period when the risk of relapse is especially high
- psychotherapeutic methods have not helped before or do not suit the person's temperament
- cravings are strong and make it hard to focus on work and family
- there are no contraindications related to the heart, liver, kidneys or mental health
- the person is ready to stay sober for the required period before the procedure
- there is an understanding that regular visits to the doctor are needed after coding
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
How the Medications Used in Coding Work
Drugs in the first group (disulfiram-type therapy, also called chemical protection) block the enzyme that breaks down acetaldehyde, a product of alcohol metabolism. If the person drinks, acetaldehyde builds up and causes hot flushes, palpitations, nausea, shortness of breath and a drop in blood pressure. This reaction can be life-threatening, so coding with these drugs requires a thorough examination and the patient's full understanding of the consequences.
Drugs in the second group — opioid receptor antagonists — work differently: they reduce the “reward” from alcohol and the strength of cravings, but do not cause a severe reaction when alcohol is consumed. This approach is described in NICE and WHO guidelines as part of the treatment of alcohol dependence. The choice between the groups depends on the person's health, expectations and past treatment experience, and is discussed with the doctor individually.
How the Medication-Based Coding Procedure Works
You can start with an online consultation: the doctor learns about the drinking history, illnesses and current medications and explains the options. The in-person stage includes an examination, blood tests, an ECG and confirmation of the period of sobriety. Then the drug and its form are chosen — an injection or a subcutaneous implant — and informed consent is signed. Administration takes 15–40 minutes, after which the patient stays under observation for about half an hour. Next comes a schedule of follow-up visits.
The procedure is not performed while a person is intoxicated, if the period of sobriety is too short, with severe heart and vascular disease, liver or kidney failure, epilepsy, pregnancy or an acute mental disorder, or without voluntary consent. If, after coding, the person does drink and develops choking, chest pain or sudden weakness, call 103 or 112 immediately and tell the medics about the coding.
How we help
Injection
The drug is given intravenously or intramuscularly in the treatment room. The effect begins quickly and lasts for a certain period, which depends on the drug and its form. An injection is convenient because it does not require a surgical procedure and can be repeated if needed. Before the injection, the doctor once again checks how the patient feels and their blood pressure, and confirms the period of sobriety.
Subcutaneous implant
An implant containing the drug is placed under the skin through a small incision under local anesthesia. It releases the active substance gradually over months. The procedure takes 20–30 minutes, and the wound needs care for a few days afterward. If redness, swelling or pain appears at the implant site, you should see a doctor rather than wait for it to go away on its own.
Medications that reduce cravings
Opioid receptor antagonists, given as long-acting injections or tablets (opioid blockade), reduce the pleasure from alcohol and the strength of the urge to drink. They do not cause a dangerous reaction in the event of a relapse, so they suit people who are afraid of a “chemical barrier.” However, they also require an examination, liver monitoring and consideration of the patient's other medications.
Follow-up after coding
We schedule follow-up visits after a week, after a month and then according to plan. At these visits we assess well-being, cravings, sleep and mood, and check blood tests if needed. If doubts or difficult situations arise, you can see a Akalam doctor or psychotherapist earlier than scheduled — this is part of treatment, not a sign of failure.
How treatment works
- 01Call or WhatsAppThe administrator and the doctor on duty clarify the situation and tell you what to do right now.
- 02Examination or consultationThe doctor visits your home, sees you at the clinic or joins by video.
- 03Treatment planWe choose the format — at home, inpatient, psychotherapy or rehab — with a clear price.
- 04Ongoing supportYour doctor and psychotherapist stay in touch: follow-ups, family support and relapse prevention.
Myths and facts
MythThe drug makes a person a non-drinker forever
FactAny drug works for a limited time and does not eliminate the addiction. It provides a period of sobriety during which it is important to recover and change one's lifestyle. When the period ends, the risk of relapse depends on how well the person has prepared for life without alcohol.
MythCoding can be “removed” at home with folk remedies
FactThere is no safe way to “neutralize” the drug on your own. Attempts to drink in order to “test” it, or to “undo the coding” with home remedies, can lead to a severe reaction and a threat to life. Any questions about the duration or reversal of coding are discussed with the doctor.
MythAn implant is dangerous and always causes complications
FactWith proper technique and sterile conditions, complications are rare. Local reactions are possible — swelling, redness, slight tenderness — and they usually go away. It is important to follow the wound-care recommendations and tell the doctor about any changes.
Prices: Medication-based coding
| Medication-based coding | 40 000 ₸ |
| Addiction doctor home visit: examination and advice | 20 000 ₸ |
| Repeat IV drip the next day | 20 000 ₸ |
| 24 hours in the inpatient unit | 45 000 ₸ |
| Phone consultation | free |
Prices are approximate: the doctor confirms the exact cost after the examination, before treatment starts.
Confidential
We do not register patients with state dispensaries or share information with employers. You do not have to give your surname; doctors arrive in unmarked cars. Medical confidentiality is protected by the Code of Kazakhstan “On Public Health and the Healthcare System”.
Clinic addresses
FAQ
How long do you need to stay sober before the procedure?
The minimum period of sobriety is set by the doctor depending on the chosen drug and the person's health — usually from several days to a week or longer. Some drugs can cause a dangerous reaction if traces of alcohol remain in the blood, so recent drinking must never be concealed.
How is an injection different from an implant?
An injection is given into a vein or muscle and does not require an incision, while an implant is placed under the skin and gradually releases the drug. They differ in duration of effect, convenience and how they feel. The doctor will help choose an option based on the patient's health, lifestyle and wishes.
What does it feel like after the procedure?
Most often the person feels nothing special; sometimes there is mild weakness, a headache or drowsiness on the first day. After an implant there may be slight tenderness at the incision site. If a rash, difficulty breathing or severe pain appears, tell the doctor immediately or call 103.
Can I take other medications?
Many medications are compatible with coding, but some — for example, alcohol-based tinctures, syrups and certain painkillers — need to be avoided or approved by the doctor. Before the procedure, tell the doctor about all the medications you take, and afterward, consult them before starting any new treatment.
What should I do if I feel the urge to drink?
Do not “test” yourself — contact your doctor or psychotherapist. Cravings after coding are common, especially under stress or in familiar situations. They are discussed at appointments, support is adjusted, and sometimes treatment is changed. Reaching out in time helps prevent a relapse.
Can the procedure be done anonymously?
Yes. At Akalam, medication-based coding is carried out anonymously, without registration with the state addiction (dispensary) registry, on the basis of a contract and written consent. Information about the patient is a medical secret and is not shared with employers or other parties, except in cases expressly provided for by the law of the Republic of Kazakhstan.
Sources and review
Prepared by the Akalam medical editorial team based on:
- ICD-10 and ICD-11: mental and behavioural disorders
- Clinical protocols of the Ministry of Health of Kazakhstan
- Code of Kazakhstan “On Public Health and the Healthcare System”
- WHO: mental health and substance use
- NICE and APA clinical guidelines
This information is for reference and does not replace a doctor's consultation. Editorial policy