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Clinical Services

In May, 2006, NPCJS hired a Clinical Supervisor to begin the framework for developing services for all clients that are afflicted with chemical dependency issues, as well as all domestic violence related matters for the County and Court.  At the end of budget year 2008, our department secured private provider status with the Department of Health and Welfare and Business Psychology Associates (BPA), and thus we can work with clients who are also not involved in the legal system.  So, to date (2010) we are pleased to announce that we offer:

  1. Domestic Violence Assessments and Treatment for any person in need of that service;
  2. Substance Abuse Education and Individual treatment for residents of the Region II Juvenile Detention Center;
  3. For the adolescent population, we offer three (3) IOP groups per week and one (1) OP group per week, as well as a host of individual sessions to augment the treatment;
  4. For the adult population, we offer a host of IOP groups and OP groups, as well as individual sessions.
  5. All of our clinicians have a Master's Degree, and are GAIN-I certified.
  6. And with the newly remodeled building, the Clinical Department has moved from their leased off-site building to the main office location in Feb, 2010.

Clinical Fee Information

Please call our office clinical fee information.

Substance Abuse Information


No longer is it just a few deviant teens who use alcohol, tobacco, and other drugs. Today the teens who do not drink, smoke, or use other drugs are often made to feel left out.

There are many pressures on teens to use alcohol, tobacco, and other drugs, the strongest of which comes from the adolescent’s peer group. Besides the knowledge of drug use among their friends and celebrities, youths are bombarded daily by television and other media messages promoting adventure and fun associated with the use of alcohol and tobacco. What is most important though is that adolescents tend to mimic the behavior of parents and other adults. Finally, be aware that your child is at higher risk if there is a history of substance abuse in the family, as research has confirmed that there is a genetic determinant in substance abuse.


Teenagers may try alcohol and other drugs for the same reasons they experiment with other behaviors. Here is a list of possible motivations:

  • Curiosity - desire to seek out new experiences
  • Peer Group Pressure - security that comes from being like others
  • Insecurity - desire for affection, identity, and respect
  • Boredom - lack of excitement, zest or challenge
  • Escape - refuge from problems, loneliness, or failure
  • Defiance of Authority - rebellion against parents, school, or society in general
  • Standards - lack of appropriate values for maintaining health and well-being
  • Ignorance - lack of actual information about the dangers of drug and alcohol abuse
  • Physical and Emotional Problems - overcome pain, stress, and strain
  • Stimulation - obtain increased physical and/or mental energy quickly and seemingly effortlessly


There are many signs and symptoms that go along with substance use and abuse. The following lists describe some of the changes that you may see taking place in your teen, at home, or at school. Keep in mind that the majority of these behaviors and signs begin to show up after 6-9 months of frequent substance abuse and do not show up immediately after a teen has begun to use drugs/alcohol.

Physical symptoms

  • Acting intoxicated
  • Bloodshot, red, or glossy eyes; droopy eyelids
  • Imprecise eye movement
  • Repressed physical development
  • Loss of appetite or unexplained, significant weight loss (10-15 lbs in one month)
  • Abnormally pale complexion
  • Wearing sunglasses at inappropriate times
  • Neglect of appearance, dress, and personal hygiene
  • Having the “munchies”
  • Slurring speech and changes in vocabulary patterns

Behavioral symptoms

  • Unexplained periods of moodiness
  • Loss of motivation
  • Depression, anxiety, or irritability
  • Erratic levels of energy or fatigue
  • Conflict within family: extreme anger or withdrawal
  • Strongly inappropriate overreaction to mild criticism or simple requests
  • Loss of ability to assume responsibility
  • Need for instant gratification
  • Decreased interaction and communication with others
  • Change in values, ideas, beliefs
  • Changes in friends, unwillingness to introduce friends to family
  • Preoccupation with self, less concern for feelings of others
  • Illegal behavior: shoplifting, curfew violation, possession of drugs/paraphernalia
  • Loss of interest in previously important things such as hobbies and sports
  • Noticeable increase or decrease in monetary status
  • Lying, denying, secretiveness

School Changes

  • Steady decline in academic performance; drop in grades
  • Sleeping in class
  • Poor short-term memory; decreased concentration or attention span
  • Slow to respond, forgetful, apathetic
  • Increased disciplinary or behavioral problems
  • Loss of motivation, interest, energy, participation in school activities and classes

Physical Evidence

  • Odor of marijuana in room or on clothing
  • “Bongs” (water pipes, usually glass or plastic)
  • Pipes, pipe filters, screens, strainer
  • “Joints” (marijuana cigarettes rolled by hand and twisted at the ends)
  • Cigarette rolling papers
  • Powders, seeds, leaves, marijuana plants, mushrooms
  • Small spoons, straws, razor blades
  • Eye drops, mouth wash
  • Incense or room deodorizers
  • Empty alcohol bottles or cans
  • Stash cans (soft drink, beer, deodorant, and other cans that unscrew at the top or bottom)
  • Capsules or tablets
  • Plastic baggies or small glass vials
  • Drug-related books, magazines, comics
  • “Roach clips” (metal clips to hold the butts of the marijuana joints)

By themselves, some of the symptoms may be typical of an adolescent growing and changing, however, if several symptoms are noticed with increased frequency, you may wish to seek further help from a trained professional. This professional will determine if education, counseling, or possible inpatient treatment is needed to stabilize your child.


The first drugs to which people are exposed and with which they experiment are known as the gateway drugs. Traditionally these refer to:

  • alcohol
  • tobacco
  • marijuana
  • glue, propellants, and other inhalants (The sniffing or “huffing” of propellants, such as those found in the aerosol containers of many household products, can cause brain damage or death.)

NullAccording to D.A.R.E. (Drug Abuse Resistance Education), most drug-dependent people began their cycle of addiction experimenting with gateway drugs.

Our teens are not immune to exposure to these drugs. Alcohol is the most popular drug among youths and adults in our country, and studies of school-aged children indicate that initiation of daily cigarette smoking (not occasional use) is highest among 12-14-year-old students.




  • Nicotine is a highly addictive nerve stimulant.
  • There are 4,000 chemicals and nearly 50 cancer-causing substances in cigarette smoke.
  • 85% - 90% of those who smoke as adults begin by age 19.
  • Smoking is responsible for one out of three deaths in the United States.
  • A teen who smokes cigarettes daily is 20 times more likely to be a marijuana user and 13 times more likely to be a daily user of other drugs than a teen who does not smoke.
  • 80% of adolescent cigarette smokers are also users of marijuana.
  • Nonsmokers exposed to environmental tobacco smoke are at an increased risk for the same problems as smokers.
  • Teenagers are prime targets of tobacco advertisers, and each year, one million teenagers will start smoking.


  • Alcohol is called a drug because its main ingredient, ethanol, in higher doses, acts as a general anesthetic (like ether).
  • Alcohol is a depressant, and as such, it slows the brain and central nervous system. When large quantities are ingested, it is possible for the brain to shut down partially or completely, resulting in a coma, respiratory failure, or possibly death.
  • More than a third of America’s 3.3 million alcoholics are under the legal drinking age.
  • 30% of high school seniors get drunk once a week and 6% are daily drinkers.
  • Adolescents can become alcoholics in 3-24 months versus 10-15 years for adults.
  • In the adolescent, very low blood alcohol levels can produce irrational judgment and reduce self control.
  • Incomplete muscle formation, bone growth, and juvenile fat deposits decrease the teen’s resistance to alcohol toxicity.


  • Marijuana is now 2-10 times stronger than it was 10 years ago. Hybrid forms of marijuana like sinsemilla (seedless) contain much more of the active ingredient, tetrahydrocannabinol (THC), rendering it even more potent. Potency also varies from climate to climate and ounce to ounce.
  • Cannabis inhibits short term memory, slows reaction time, and impairs visual tracking. Frequent use is also linked to cognitive impairment (an inability to understand concepts).
  • Frequent users’ rate of social development may slow. A pattern of denying problems and irresponsibility in facing obligations can develop.
  • Some frequent users find it hard to stay motivated, and develop a lack of initiative and concern about the future. Often a pattern of superficial relationships develops with people who expect or demand little of the user.
  • Cannabis is stored in the brain, testes, ovaries, and other fatty organs for up to a month or more and is detectable by urine tests. Detection periods span 4-6 days in acute users and 20-50 days in chronic users.
  • Marijuana is up to 200 times more likely to cause cancer than tobacco smoke, and frequent use is linked to an increase of lung cancer, bronchitis, and emphysema.
  • Marijuana depresses the immune system, therefore it is more difficult for the user to fight off colds, flus, or other viruses.
  • Cannabis speeds a user’s heart by as much as 50%, increasing risks for anyone with heart disease.
  • Marijuana inhibits nausea and allows a person to consume large quantities of alcohol without getting sick. As a consequence, death due to alcohol overdoses has escalated among teenagers.


Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain. Methamphetamine is chemically related to amphetamine, but the central nervous system effects of methamphetamine are greater. Both drugs have some limited therapeutic uses, primarily in the treatment of obesity.

Methamphetamine is made in illegal laboratories and has a high potential for abuse and addiction. Street methamphetamine is referred to by many names, such as "speed," "meth," and "chalk." Methamphetamine hydrochloride, clear chunky crystals resembling ice, which can be inhaled by smoking, is referred to as "ice," "crystal," "glass," and "tina."

Health Hazards
Methamphetamine releases high levels of the neurotransmitter dopamine, which stimulates brain cells, enhancing mood and body movement. It also appears to have a neurotoxic effect, damaging brain cells that contain dopamine as well as serotonin, another neurotransmitter. Over time, methamphetamine appears to cause reduced levels of dopamine, which can result in symptoms like those of Parkinson’s disease, a severe movement disorder.

Methamphetamine is taken orally or intranasally (snorting the powder), by intravenous injection, and by smoking. Immediately after smoking or intravenous injection, the methamphetamine user experiences an intense sensation, called a “rush” or “flash,” that lasts only a few minutes and is described as extremely pleasurable. Oral or intranasal use produces euphoria—a high, but not a rush. Users may become addicted quickly, and use it with increasing frequency and in increasing doses.

Animal research going back more than 20 years shows that high doses of methamphetamine damage neuron cell endings. Dopamine- and serotonin-containing neurons do not die after methamphetamine use, but their nerve endings (“terminals”) are cut back, and regrowth appears to be limited.

The central nervous system (CNS) actions that result from taking even small amounts of methamphetamine include increased wakefulness, increased physical activity, decreased appetite, increased respiration, hyperthermia, and euphoria. Other CNS effects include irritability, insomnia, confusion, tremors, convulsions, anxiety, paranoia, and aggressiveness. Hyperthermia and convulsions can result in death.

Methamphetamine causes increased heart rate and blood pressure and can cause irreversible damage to blood vessels in the brain, producing strokes. Other effects of methamphetamine include respiratory problems, irregular heartbeat, and extreme anorexia. Its use can result in cardiovascular collapse and death.


  • LSD is one of the most potent chemicals known to affect the human brain. It appears to work by profound disruption of brain neurotransmitters.
  • A white, odorless crystalline material, LSD is diluted and sprayed on sheets of blotter paper for oral ingestion. This paper, known as “Blotter Acid,” frequently has designs printed on it.
  • The “high” lasts for six to 14 hours.
  • Mental effects include changes in perception, thinking, emotion, arousal, and self-image.
  • Even a small dose of LSD can unpredictably cause toxic delirium or “bad trips.”
  • Terrifying illusions and hallucinations may precipitate panic attacks or reckless behaviors.
  • 16% of student LSD users reported the use of other illegal drugs, such as PCP, Ecstasy, Speed, Ice, or Heroin.

LSD is experiencing a comeback in the 90's among white, middle-class high school and college students. LSD is the third most frequently taken drug, after alcohol and marijuana, according to one study of adolescent users. In 1995, there were more LSD-related arrests, emergency room visits by adolescents, and violent behavior, including suicide, homicide, and accidental death than had previously been recorded.

Chronic aftereffects of LSD use include: chronic or intermittent psychotic states, recurrent depression, and Post-Hallucinogenic Perceptual Disorder (PHPD), e.g., flashbacks characterized by periodic hallucinatory imagery, months or years later.

LSD use is increasing sharply in the youth across the country. It is inexpensive, very available, easy to conceal, easy to administer, and use is difficult to detect through observation or testing.


  • Inhalant abuse is always dangerous and can be deadly.
  • Risks include suffocation, heart failure, and organ damage.
  • Inhalants are intoxicating in much the same way as alcoholic beverages. Abusers often act confused and giddy, and may appear clumsy and accident-prone. Odd and unpredictable behavior is also characteristic of inhalants.
  • A user’s lack of judgment and diminished physical coordination can pose significant danger.
  • Headaches, upset stomach, vomiting, diarrhea, and poor reflexes are among the side effects produced by inhalants.
  • Users may become dependent and undergo painful withdrawal symptoms when they stop using.
  • Many users of inhalants move onto other drugs, particularly alcohol, marijuana, and barbiturates.

Because they cost little and can be obtained easily, inhalants have become the drug of choice for many adolescents. Inhalants include gasoline, butane, toluene products (glues, acrylic paints, paint thinners), halogenated hydrocarbons (freon, solvents, spot removers, typewriter correction fluid), nitrous oxide (dental anesthetics, whipped cream propellants, automotive power boosters), and alkyl mitrites/nitrates (called “poppers” or “snappers”), which include room deodorants and liquid incense. Currently, the most popular inhalants are nitrous oxide (called “Nitty”), propane, and air fresheners.


  • Stimulants - These drugs, sometimes called uppers, activate a pleasure center in the brain. Stimulants include caffeine pills; amphetamines such as Benzedine and Dexedrine; Ritalin (called “Ritz”); and cocaine. Cocaine comes in powder or rock form and can be referred to as “Rock,” “Crack,” “Blow,” or “Linen.” These drugs speed pulse rates and increase blood pressure, and they may contribute to insomnia and appetite suppression. Some stimulants, such as No-Doze, weight-loss pills, stay-alert pills, are also available over-the-counter.
  • Hallucinogens - Drugs such as PCP, MDA, DMT, STP, mescaline, peyote, and psilocybin relax inhibitions and can cause hallucinations that affect a person’s thinking, awareness, and sensations, as well as dramatically increases blood pressure and produce irregular heartbeats. Teens use the term “tripping” to describe the high obtained from these types of drugs. The most popular hallucinogens used today, aside from LSD, are mushrooms (called “shrooms”), Ecstacy, Ketamine (called “Special K”), and motion sickness pills.
  • Anabolic Steroids - Increasingly popular among teenagers, anabolic steroids (also called ‘roids, the juice, pump, or hype) build body muscle mass and enhance athletic performance. Some athletes start taking steroids because they think they must do so in order to win. Other teens use them to grow bigger and stronger at any cost. There are many side effects both physical and emotional. Considering the potential risks, steroids should be considered serious drugs of abuse even though they aren’t used to get high.
  • Narcotics - The abuse of opiates has occurred for years. Injectable heroin has been perhaps the best known opiate to be abused, but people have also abused opium, morphine, methadone, codeine, Dilaudid, Percodan, and Darvon. Currently, opium (called “Tar”) and brown heroin (called “Brown”) are popular in this area.



The key to reduce the risk of substance abuse is PREVENTIVE PARENTING. Sit down together and discuss your expectations. Explain that these behaviors are not allowed, why they are not allowed, and follow through with consequences. Your child/adolescent needs this external control from you at a time when his/her own internal controls are not developed. Studies also show that the likelihood of teens using drugs decreases when they know usage would upset their parents.

  • Don’t control, contribute. Give your teen positive alternatives for having a good time without alcohol or other drugs.
  • Do things with your child, but not all the time. They need their space too.
  • Talk to other parents and find out their rules. It is helpful to have support when making decisions, but make sure YOUR teens know YOUR rules.
  • Get to know people and organizations in your community who can be used as resources for your family.
  • Take an interest in your teens’ friends. The biggest indicator of whether adolescents will drink is their group of friends.
  • Be interested in social events your teen attends, as well as their academic and athletic events. It is helpful to know where your child is and who is with them.
  • Maintain communication with your children; it is the key. Concentrate more on discussion and less on establishing rules (but make sure the rules are established and known).
  • Do not deny that your teen could be using alcohol or other drugs. If you suspect he or she is a user, get help fast.
  • Model appropriate behavior. Remember, what parents do counts; parents are a child’s most important influence.


These are more suggestions on ways to discuss drug prevention with your teen.


Understanding - “I realize you are under a lot of pressure from friends to use drugs.”

Firmness - “As your parent, I cannot allow you to engage in harmful activities.”

Support - “I’ll help you find a way to say ‘no’ to drugs.”

Self-examination - “Are my own alcohol and drug consumption habits exerting a bad influence on my child?”


Sarcasm - “Do you think I don’t know what you’re doing?”

Accusations - “You’re lying!!”

Stigmatizing - “You’re a terrible person.”


  • Be Aware of their attitudes.
  • Be Alert to their environments.
  • Be Around their activities.
  • Be Assertive in your parenting.
  • Be Awake when they come home.



Some parents unintentionally enable their teen’s risk-taking behaviors, which may include the use of alcohol and other drugs. Enabling protects the child from experiencing the consequences, and though most enabling is done out of care and love with the sincere belief that help and protection will solve the problem, it only makes the problem worse.

Some Enabling Behaviors

  • Rescuing the child from trouble at school, on the job, with the law, or trouble with the other parent
  • Taking on responsibilities that actually belong to the teen
  • Keeping “peace at any price” in the belief that “good” marriages/families are free of conflict
  • Failing to identify or express feelings (this is called “stuffing”)
  • Minimizing the problem (“He/she doesn’t drink/use that much or that often.”)
  • Protecting the image of the user and the family
  • Bargaining with the drinker/user (“You can drink as long as it’s in our home or you don’t drive.”)
  • Blaming, lecturing, arguing, etc.
  • Waiting, enduring (“It’s just a phase, it will pass.”)
  • Denying the possibility of any chemical use or dependency

Justice Services

Shawn McDowell

E-mail Shawn



Office Location
140 10th Street
Lewiston, ID 83501

Mailing Address
P.O. Box 896
Lewiston, ID 83501


Contact Us



Office Hours
8:00 AM to 5:00 PM



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