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Alternatives to incarceration such as drug court have gained increased attention, particularly as a response to a rise in opioid overdose death. In the program, participants work with a drug court team, comprised of criminal justice actors and treatment providers. The team monitors client success through a variety of awards and sanctions. Upon completion of the program, original charges drop; if the participant fails to comply, charges stand and they are sent to prison. Given the mixture of care and control, scholars have described drug court as fostering a kind of therapeutic surveillance. In conducting courtroom observation, I extend the work on therapeutic surveillance by detailing competing addiction narratives participants are made to portray during court sessions with the judge: that of a redeemable productive citizen, fit for the program, versus a criminal “addict” who, without the program, will return to a life of addiction and inevitably “die or go to prison.” In turn, I consider the significance of social control forged through the overlapping of treatment and criminal justice responses to addiction.