Case #48: Narcological Clinic (Moscow) — links as the foundation, content as the multiplier

Владислав Бобров (Mdevostator)

Founder of tier1.shop · PBN Specialist, in SEO since 2009

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Case from the Tier1.shop collection · 2026 · ← all cases

We decided to analyze this case more honestly than usual — because the result here was made by two. We placed links, and the client simultaneously wrote articles for the blog. The result is impressive: the site of a private narcology clinic grew practically from zero to 2 310 visits/month according to Semrush and 8 938 according to Ahrefs. But attributing this growth entirely to links would be untrue. Therefore, below we show with a separate graph which part of the traffic on which pages grew — and what of this was done by links, and what by the client's content.

Result in brief: 📈 in the first 15 months (even before the client's blog started working) the site rose from 9–10 visits/month to 414 according to Semrush and to 2 185 according to Ahrefs — this is the period when all growth occurred on the pages where we placed links. 📈 Keywords in the top-3 became 53 versus zero, in the top-4–10 — 232 versus one; according to Ahrefs, the top-3 grew from zero to 449. 📈 Overall visibility (all keys in the top-50) — from 7 to 645. Then, in 2026, the client launched informational articles, and they added another about 1 700 visits/month — already on a prepared domain.

Starting point

The site is young: it appeared in the Semrush database in autumn 2023 and throughout 2024 it stayed at 6–15 visits per month — effectively zero. Ahrefs showed 0–1 visits during that period. There were no keywords in "money" positions at all: zero in top-3, one in top-4–10.

Meanwhile, the niche is one of the hardest for a young site. Narcology is medicine, meaning a topic for which search engines have increased requirements for expertise and trust: it is significantly harder for new sites to break through here than in ordinary commerce. Plus high competition: in the capital, dozens of clinics fight for the same queries.

What was done

Placements went in three waves with long pauses. Autumn 2024 — 4 eternal links (one in September and three in October). Then a pause of almost a year, and in October 2025 — a wave of 7: four eternal and three for 1 year. Spring 2026 — another 9 links for 1 year, exactly three in April, May, and June. Total 20 placements: 8 eternal and 12 annual. All from different PBN home pages, no repeat donors; all are active to this day.

Target pages are the clinic's commercial services: detox from binge drinking (7 links — main goal), calling a narcologist home (4), home page (3), alcohol coding (2), as well as one link each to addiction treatment, home coding, forced detox from binge drinking, and drug drip. Anchor texts are commercial with intent and geo: "detox from binge drinking at home", "narcologist home", "alcohol coding in Moscow", "private narcological clinic". 17 unique formulations out of 20.

Dynamics by Semrush (monthly data, Russia)

• The first six months — almost silence. After the autumn wave of 2024, traffic started going up, but slowly: 10–20 visits in winter, 37 in June 2025. For comparison, Ahrefs recorded the shift earlier and more clearly — starting from November 2024 (more on this below). This is a normal picture for a young site in a difficult topic: link weight accumulates first, and only then converts into positions.
• July 2025 — the first noticeable jump: 134 visits. Then a decline to 62–67 in August–September, coinciding with the Google spam update (August 26 — September 22, 2025), and recovery by November.
• The October 2025 wave (7 links) — the turning point. November 140, December 414. The December Google core update (December 11–29) the site passed with growth.
• 2026 — reaching a new level: 888 in March, 1 102 in April, 2 310 in July. The March core update (March 27 — April 8) was also passed with growth. But it was here that a second factor joined the result — the client's content, and there is a separate section about this.

Positions are the most indicative part. 📈 Keywords in the top-3 were zero at the start — it became 53. In the top-4–10 there was one — it became 232, and this is a record for the series, set right now. General visibility (gray dashed line, all keywords in the top-50) grew from 7 to 645. Note the shape: the gain in positions happens in steps and noticeably accelerates after each wave of placements.

Ahrefs dynamics (daily data, world)

Ahrefs confirms the history independently and sees it in its database earlier than Semrush: the first non-zero values appeared as early as November–December 2024, 1–2 months after the first wave (7 and 11 visits versus zero). Then — 68 in April 2025, 263 in July, 722 in August and 2 185 by December 2025. Peak — 9 743, now 8 938. 📈 Keywords in the top-3 according to Ahrefs — 449 versus zero, in the top-4–10 — 1 145.

The discrepancy in absolute figures between services is normal: different keyword databases and different coverage (we look at Semrush via the Russian database, Ahrefs — globally). The important thing is that the shape of the curve is the same for both, and the turning point falls on the same months.

What the links did here, and what the client's content did

Now for the most important part. If we simply show the domain growth of 230 times and place our count of 56 thousand next to it, it would be a beautiful but dishonest picture. We broke down the traffic by pages on a monthly basis — here it all is:

In blue — the pages to which we placed links. In orange — articles in the client's blog, to which we did not place a single link. What follows from this:

• The first 15 months of the blog have no traffic at all. Its articles began to attract visitors only in January 2026. Everything the site gained up to that moment — 414 visits/mo according to Semrush and 2 185 according to Ahrefs — went to the service pages and the home page, meaning where our links went. In separate months, the "withdrawal from binge drinking" page alone provided up to 41% of the total domain traffic (July 2025) and 30% in December 2025.
• From 2026, the picture changes.The client launched informational articles — about the time it takes to remove substances from the body, about alcohol removal, about IV drips. They took off: now three articles provide about 1 700 visits out of 2 310, meaning three quarters of all traffic. There are no links from us to them.
• It is impossible to divide the contribution in percentages, and we will not do that. One can only note the observation: the articles reached the top on a domain that, by that point, had already been gaining link weight for a year and a half and had top-3 positions. In the medical niche, where search engines have special trust requirements, it is much harder for a young site without external links to break through. Our role is the foundation; the content takeoff is the client's merit.

Another detail visible on the graph: the gray "other pages" zone also grows throughout the period. This includes the clinic's home page — we placed 3 links to it, but it cannot be measured separately in Semrush (the service combines the home page with the domain), therefore in the breakdown it honestly went into "other", not into our blue segment.

Breakdown by target pages

We ran every target page through Semrush: traffic before the first link to it and now. Anchor text repetitions are marked by density: ×N in one day — all repetitions on one date, ×N in one batches — within a month, ×N for M mo — spread over time. Only the third type is encountered here. We show everything, including pages without a result:

We cross-checked the result with real demand via Wordstat (Moscow) to avoid guesswork. The pages that grew have expected demand: "withdrawal from binge drinking" — 6 634 impressions per month, and this is the main goal of the campaign (7 links, 141 visits at peak). Two of the pages that didn't grow are honestly explained by demand: "forced withdrawal from binge drinking" — only 6 impressions per month, "at-home coding" — 98. The link simply has nothing to work with.

But two others break the simple explanation: "alcoholism treatment" has 2 704 impressions per month, and "alcoholism coding" — 1 761, the demand is quite active — but the pages still didn't grow. Both received one or two links, while those that grew received four to seven. It seems to be a matter of volume: one link for a competitive query in a medical topic is not enough. This explanation is consistent with the data, but is not proven by a single case.

The role of anchor text. 17 unique formulations out of 20. There are two repetitions, both spread over time: "at-home withdrawal from binge drinking" — three times in 12 months, "narcologist at home" — twice in 8 months. This fits within a safe interval, and no negative effect is visible in the case data: both pages are in the plus. At the same time, our position remains unchanged — it is better to avoid anchor duplicates altogether: in our experience, the probability of page pessimization when placing a link with an already used anchor exceeds 50%, and the drop happens quickly. If repeating, then no more than once per search engine update — approximately once every 1–2 months or less, as happened here.

And a disclaimer to the entire page-by-page slice: Semrush and Ahrefs are third-party services that estimate traffic based on their own keyword databases. Only the site owner can see the real figures in Google Search Console and Yandex.Webmaster, and they may differ. "Zero in Semrush" does not mean that the page is receiving no visits at all.

Conclusions from the case

• How often and how many. 20 links over 22 months in three waves, averaging ~2 500 ₽/мес. Almost a year passed between the first and second wave — and the pause did not reset the accumulated progress: the site continued to grow during the pause. But the most noticeable turning point was the second wave (7 links in a month) — after which traffic tripled in two months.
• How long to wait in a difficult niche. Here, you should prepare for the long haul: Ahrefs saw the first non-zero shifts after 1–2 months, but steady growth according to Semrush began only 9 months after the first link. In medicine, this is normal — if you expected results within a month, your expectations should be adjusted.
• Which pages. Service pages with broad demand that received several links are working. A single link to a narrow formulation of an effect provides almost nothing.
• Links and content reinforce each other. The main conclusion of this case. Links raised the domain from zero to the first few hundred visits and to top-3 positions — and when the client published articles, they reached the top quickly and provided exponential growth on a ready-made foundation. The reverse order works worse in this niche: articles on a domain without link weight compete with medical sites that have this weight.
• Budget. 56 000 ₽ over 22 months — approximately like one or two weeks of a contextual advertising contractor's work, while the links continue to work after payment.

All conclusions are guidelines from a single case, not guarantees: another site, niche, and geo will have its own numbers.

Verifiability

The client's domain is hidden due to the privacy policy, so instead of a link to the site — screenshots from analytics services (estimates in the interfaces and on our graphs may differ: different databases and regions; the shape of the curve matches).

Semrush Domain Overview, Russian database, full history (extra series disabled — only those on our graphs remain): years of zero and a surge that began after the start of placements. Bottom panel — keywords in top-3 and top-4–10.

Ahrefs, organic traffic over 5 years: flat zero until autumn 2024 and growth to current maximums.

Ahrefs, keywords by position: all baskets are growing from zero.

How we measured

Number of links, dates, types, and terms — from the Tier1.shop order database (only completed placements with the date of placement; all 20 are active). Traffic and positions — Semrush (Russian database — client geo, monthly points) and Ahrefs (world, daily points). We built the "where traffic comes from" breakdown by taking separate rows for each target page and blog articles and subtracting them from the total domain traffic; the remainder is attributed to other site pages. Both services are third-party estimates based on their own keyword databases: accurate data is seen only by the site owner in Google Search Console and Yandex.Webmaster.

*Costs are calculated at current Tier1.shop prices; the client was placed at the prices of their time — the order of magnitude is the same.

Honestly

• Three quarters of today's traffic are the client's articles. We did not place links to them and do not claim this result. Our measurable area is the growth to 414 visits according to Semrush and 2 185 according to Ahrefs over the first 15 months, service pages, and top-3 positions.
• What else the client did, we do not know. Work on the site is possible that we cannot see: technical optimization, page edits, other link sources. The contribution in percentages is speculation, so we do not calculate it.
• There was a dip. August–September 2025: from 134 down to 62 visits, the window coincided with a Google spam update. Recovered in two months, links were not removed during this period.
• Some pages did not grow. Four out of eight goals yielded single visits or zero — they are in the table above, we are not hiding them.