Your blanket statement isn't true for everyone though. Many states do not have confidential programs or the confidential programs are really hard to access. I've seen nurses lose licenses over nuances in the monitoring contract or mistakes in UA testing/results or from not being able to afford the program -- not from actual relapse.
You're so intent on proving the privilege of these programs that you seem to be ignoring your own privileges? People can certainly spiral into profound financial crisis from these programs. Over half of all Americans live paycheck to paycheck. Throw in a mortgage, a few kids to support, student loans, etc and, yeah, losing your house or having to file bankruptcy can feel like punishment. Yes, removing a nurse from the job might be necessary to protect the public but you can't begrudge someone who may have lost everything the feeling that they are being punished.
I've spent a bit of time in jail and I've spent a lot of time locked on some not-so-nice psych units. Did your friend mean prison? I would take the boredom of jail over many of the psych units I've been on. And I'd take the boredom, cavity searches, and terrible food of both places over being screamed at by another healthcare professional about the formatting of a UA result.