I count people’s drinks. I don’t mean to do it, and I’m not proud of it, but I imagine it’s a learned behavior. I grew up with addiction around me, and believing that people would adhere to the limits they set for themselves was difficult, at best. So I started counting drinks, and I’ve never stopped. It’s not the only thing I pay attention to because, as a child of addiction, I am hypervigilant. When someone who is supposed to take care of you is unreliable, you start paying very close attention to your surroundings in order to keep yourself safe. Friends at work used to move my stapler just to see how quickly I’d return it to the proper position on my desk. My niece, while she was living with me, once told me that she wouldn’t be surprised if I knew she’d taken a Kleenex even if I wasn’t in the house. Again, I don’t mean to be this way, and I’m not proud of it, but it’s a learned behavior.
Just like lying is a learned behavior for someone suffering from an addiction. They don’t TRY to lie. They don’t practice lying. And sometimes they aren’t even really intending to lie. It just happens because they’ve learned to lie.
“What time will you be home?” “Right after work.“
Can you imagine the fight that would happen in the moment if, knowing a wife was going out with friends after work she told my husband that – again and again? So she learns to lie. There’s going to be a fight, but once she’s been drinking, she’s going to care less about having it. And, quite frankly, after she’s had a few, she’s going to think she can win it.
“How many drinks did you have?” “Just a few.”
She’s already late after telling her husband that she was coming home right after work…or right from the store…or right after the movie…or right after wherever. Do you really expect her to tell him that she had five drinks…plus three shots? Nah. Not gonna happen.
“Where’s all the money?” “I don’t know.” Come on now! We know her well enough to realize that she’s certainly not going to admit that the money went down her throat, up her nose, and/or in her veins! Better to play dumb.
And, of course, the addiction gets worse, as any chronic, progressive, lethal disease will when no interventions are taken. And as the addiction gets worse, the misinformation typically gets worse. Again, it may not be a full-out premeditated lie.
“How much are you drinking/using each day?” is not likely to get an accurate response from someone with a severe substance use disorder (addiction). There’s certainly some intentional subterfuge, but the misinformation is more likely caused by lack of knowledge: a drunk person isn’t counting drinks. As I like to say, alcohol – and, frankly, all mood-altering substances – turns off the good-reasoning portion of our brains. If that portion is regularly turned off, accurate information is going to be quite difficult to secure.
So why on earth do we ask people who suffer from addiction how much they are using? Mostly we do it just to say we did. Healthcare professionals are encouraged to ask, but we know that even when they do, they rarely do anything with the information. Loved ones ask because then we can say we did. “I asked, and she said she’s fine. There’s nothing I can do about it.” Employers are generally afraid to ask – Americans with Disabilities Act and all that – so they typically ignore it until it becomes too much to ignore. Then they may ask so they can start the disciplinary process.
If we recognized addiction for the disease it is, and if we treated it as the primary, chronic, progressive, lethal we say we believe it to be, we’d stop asking questions that won’t garner good answers, and we’d start testing more readily once we know that someone has an addiction.
In Wisconsin, where I live, SCRAM bracelets or some version of them for “Secure Continuous Remote Alcohol Monitoring” are used to monitor different types of offenders. Anecdotally, as my attorney friends have mentioned, offenders who want to experience recovery appreciate the opportunity to be able to tell friends they’ve drunk with in the past that they can’t drink today, because of the monitor.
SCRAM bracelets may work for some, but others may quickly find the loophole: the bracelet monitors for alcohol only. Addiction is addiction, and a lot goes into getting and staying in recovery. Prohibiting someone from using that one thing may not be enough.
The same sense of security has occurred, again anecdotally, for those who face direct biomarker fingernail testing, but that goes one better: fingernail testing can test for all substances of abuse, not just alcohol. For someone who wants recovery – or at least says that – fingernail testing is the monitoring they should get. It’s difficult to adulterate fingernails but easy to collect them, and even if someone cuts them to avoid detection, they’ll grow back relatively quickly. Plus, because of the lookback period they cover, which is up to three months for alcohol and up to six months for other drugs of abuse, the immediacy of clipping nails RIGHT NOW isn’t warranted.
A test establishes how reliable something is…as in, how reliable is the person telling me he or she hasn’t used substances of abuse? Lying may not be intentional or premeditated, but lying will happen.
Fingernail testing keeps people honest.
References
Fingernail Drug Testing
Guided by Guida 
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