> I wrote:
> "Surveillance is not treatment."
>
> 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.
Notice that I said that surveillance is _part_ of treatment. I wouldn't discount the other things Joanna listed. But I'd like to know how the support she describes would somehow _not_ include "keeping an eye on the addict so he or she doesn't start using again."
> 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 can't help but detect a degree of contempt here, in describing the "case worker" as "nothing other than an ex-alcoholic." Great: that means that anyone who's gone through AA is "nothing other than an ex-alcoholic." The struggle with one's impulses, the work involved with establishing new social patterns, the periods of self-loathing when one faces one's inability to control oneself in certain behaviors, and _then_ trying to help others through the same struggle... all that amounts to being "nothing other than an ex-alcoholic." Great choice of words, Joanne.
> 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.
Yes, I _would_ say that that couple was "under surveillance." It came from friends, family, and each other. The fact that you helped maintain a heroin-free environment indicates that _you_ were an integral part of that surveillance. (How did you keep it heroin-free without keeping an eye out for it?)
Now, let's go back to what I said earlier, about how a government-led effort at drug treatment for addicts requires some degree of surveillance. Such a program, if well-run and humane, will offer a lot more than that: it'd offer medical advice, establishment of support networks, public education, help in obtaining employment, and no end of things I'm missing here.
But it _would_ require some degree of surveillance; recovering users would be expected to demonstrate that they weren't using. It may be something as non-coercive as simply asking the patient to report once a week, and say whether they've used or not. In a therapeutic setting, and with proper privacy protections in place, drug testing could be used.