Reviewed byBaurzhan Kassymov, MDAddiction physician · updated 11.11.2026
Key facts
- ICD-10 code
- F10.2
- Who provides care
- a psychiatrist–addiction physician; the medication is given by a doctor or a treatment-room nurse under a doctor’s supervision
- Where
- the clinic’s treatment room in Almaty; implants are placed in a minor procedure room
- Duration
- examination and consultation take 1–1.5 hours, administration takes 15–30 minutes, and observation afterward lasts 30–60 minutes
- Anonymity
- anonymous, with no registry entry; a document stating the procedure and its duration is handed only to the patient
- When it is urgent
- if the person drinks after coding and has a racing heart, shortness of breath, chest pain or loss of consciousness, call 103 or 112 immediately
- Outcome
- a medical barrier or reduced cravings for the agreed period, giving time to work on the causes of the dependence
What to know
Medication-based coding is not a single drug but two different groups of medications with different mechanisms. The first blocks the enzyme that breaks down alcohol, so when a person drinks, toxic acetaldehyde builds up in the blood: the face flushes, the heart pounds, blood pressure drops and fear sets in. The second group, opioid receptor antagonists, does not cause a reaction, but it reduces the pleasure from alcohol and the strength of cravings. A Akalam doctor explains the difference before you make a choice.
In Almaty, this format is often chosen by people with busy schedules: IT professionals, executives, and those who travel frequently on business or attend toi celebrations (traditional Kazakh feasts), where turning down a drink feels awkward. The medication becomes a clear external argument: “I can’t drink for medical reasons.” But we are honest with you: a pill or an injection does not replace a personal decision. If a person comes only under family pressure and is looking for a way to “get around” it, the method can end in a dangerous reaction.
When a medication-based method may be appropriate
- the person has decided to stop drinking and wants a reliable external limiter
- relapses happen impulsively, “to keep others company” at holidays and toi celebrations
- the required period of sobriety has been completed and test results are available
- there is no serious heart, vascular, liver or kidney disease
- strong cravings make it hard to stay sober, and a medication that reduces them is needed
- the person is not ready for a psychotherapeutic suggestion session
- the person understands that alcohol in any form is dangerous after the procedure
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 work and what their limitations are
Medications that block the breakdown of alcohol act as a “stop signal”: the drug itself is barely noticeable until the person drinks. The reaction can occur even with alcohol-containing medicines, kvass, highly fermented kefir, and sauces or desserts made with alcohol. Its severity is unpredictable and depends on how much is consumed and on the condition of the heart. That is why these medications are contraindicated in people with coronary artery disease, arrhythmias or severe hypertension, as well as in older adults.
Opioid receptor antagonists work differently: they weaken the rewarding effect of alcohol, so drinking no longer brings the familiar “relief.” They are used in craving-reduction programs and are mentioned in international guidelines for treating alcohol dependence. Their limitation is that they cannot be combined with opioid painkillers, and liver disease requires monitoring of lab tests. No medication eliminates the reasons for drinking, such as stress, anxiety or habits.
How medication-based coding works
The initial consultation can be done online: over video, the doctor will ask about your history of binges, illnesses and medications, explain the groups of drugs and tell you how long you need to stay sober before the visit. Next comes an in-person appointment in Almaty: an examination, an ECG and blood tests including liver function. The doctor suggests a method and duration, explains in detail what the reaction to alcohol involves, and the patient signs an informed consent form. After administration there is a period of observation, and you receive a handout listing what you must not eat or drink and whom to call.
The procedure is not performed while a person is intoxicated or has not been sober long enough, or in cases of coronary artery disease, a past heart attack or stroke, severe hypertension, arrhythmias, decompensated liver or kidney disease, epilepsy, pregnancy or breastfeeding, acute psychiatric disorders, or allergy to the components. Giving the medication to someone secretly is unacceptable and can be fatal. If a reaction to alcohol occurs after coding, call 103 or 112.
How we help
Intravenous administration
The medication is injected into a vein in the treatment room, and the person stays under a doctor’s observation. This route is chosen when it matters that the effect begins immediately and remains controlled. The duration of action is usually limited to several months and is discussed in advance. Blood pressure and an ECG are always checked before the injection, and the person’s condition is monitored for an hour afterward.
Long-acting intramuscular form
The medication is injected into a muscle and released gradually over several weeks or months. This format is often used for opioid receptor antagonists, which reduce cravings and do not cause a reaction with alcohol. It is convenient for people who forget to take pills or travel frequently on business. If needed, the injection is repeated on a schedule agreed with the doctor.
Implant
A capsule containing the medication is placed under the skin through a small incision; this is commonly called “sewing in.” The procedure is performed under sterile conditions with local anesthesia, and the incision is closed with a stitch or an adhesive strip. Proper care of the implant site is important. The risks include inflammation and skin irritation. If necessary, the implant is removed by a doctor, never by the patient.
Tablet forms and monitoring
Some medications are taken daily as tablets, and in this case it helps to agree with family members on monitoring intake, with the patient’s own consent. Tablets make it possible to adjust the duration flexibly and to stop treatment. A Akalam doctor schedules follow-up visits and liver tests and talks with the patient about cravings so the plan can be adjusted in time.
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 medication can be secretly added to food
FactThis is life-threatening and illegal. A person who does not know about the medication may drink and have a severe reaction, up to and including a cardiovascular emergency. Medication-based coding is only possible with written consent.
MythAn implant works for life
FactEvery medication works for a limited time, from a few weeks to several months. After that, its effect wears off. It is important to use this time to treat the dependence, not just to “sit it out.”
MythIf you drink just a little, nothing will happen
FactWith blocking medications, even a small amount can cause a reaction whose severity cannot be predicted in advance. Alcohol-containing medicines, sauces and certain drinks are also dangerous. Testing whether the method works is risky.
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 I need to stay sober before medication-based coding?
For blocking medications, the sobriety requirement is stricter: usually at least several days, sometimes longer, especially after a prolonged binge. For opioid receptor antagonists the requirements are different, but it is essential to rule out the use of opioid painkillers. The doctor will give you the exact period after the consultation.
What is the difference between an injection and an implant?
These are different routes of administration. An injection is given into a vein or muscle in a few minutes. An implant is placed under the skin through a small incision and releases the medication gradually. The choice depends on the medication, the desired duration and the patient’s preferences, and it is made together with the doctor.
What tests do I need?
Usually a complete blood count and a blood chemistry panel with liver function tests, blood sugar and, if indicated, a urinalysis. An ECG is mandatory. If you have recent results, bring them with you. During a video call before the visit, the doctor will tell you exactly what is needed in your case.
Can I get coded if I have high blood pressure?
With well-controlled hypertension, it is sometimes possible to choose a medication that reduces cravings, since it does not cause sharp spikes in blood pressure. Blocking medications are usually contraindicated in severe hypertension and heart disease. The decision is made after an ECG and a blood pressure check.
What should I do if the person drank after coding?
If flushing, a racing heart, shortness of breath, chest pain or sudden weakness appear, call 103 or 112 and tell them the person has been coded and with which medication. Even if the symptoms are mild, call the doctor who performed the procedure. Do not try to “neutralize” the reaction on your own.
Which foods and medicines are off-limits after coding?
With blocking medications, anything that contains alcohol is off-limits: alcohol-based tinctures, some cough syrups, mouthwashes, sauces and desserts made with alcohol, and kvass. The doctor will give you a handout. With opioid receptor antagonists, it is important to tell any doctor about the treatment before they prescribe painkillers.
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