Brian wrote: "It's certainly part of it. Seems to me that getting someone off of drugs will involve some degree of surveillance. After all, aren't AA meetings just a way of having people check in with their case workers?"
In my experience, addictions can only be cured by the addicts themselves.... Support helps a lot. Support includes: medical support, therapy, places to go and dry out in safety and temporarily away from drugs, places and a means to live while transitioning back to a normal life.
A few years back a lesbian couple (one pregnant) came to live with me. They had just stopped using when they moved in. It took them about two and a half years to be ready to be on their own. A while after they moved out, one of them started using again, but the other is still clean after nearly six years. So, the support and the transition period was effective in one case but not in the other. But the baby was born without having been exposed to any drugs.
Folks who go to AA tell me that what helps them about the organization is the group therapy aspect of it and also having somewhere to go and something to do other than to go to a bar and drink. The "case worker" is nothing other than an ex-alcoholic.
I don't see what surveillance has to do with any of this. You could not say that the couple who lived with me were "under surveillance"; I performed no drug tests and I haven't a clue as to what a heroin addict who is using looks or acts like. The one woman who relapsed came around a few times while she was high, and I could not tell a thing. What helped them by living with me was being in a heroin-free environment and in a fairly pleasant family setting where stress was low and a capable mother figure was around to lend a hand or give encouragement when needed.
Joanna