National Certified Addiction Counselor, Level 2 (NCAC II) Practice Exam Exam

What type of issue does Janie have with alcohol, given her bipolar disorder and difficulty falling asleep without it?

1. Primary issue

2. Secondary issue

3. Tertiary issue

4. Dependence issue

The correct answer is: Secondary issue

Janie's situation demonstrates a secondary issue with alcohol in the context of her bipolar disorder. In this case, her need to consume alcohol to manage her sleep difficulties can be understood as a maladaptive coping mechanism. Individuals with bipolar disorder may often turn to substances like alcohol to self-medicate symptoms such as mood swings, anxiety, or insomnia. A secondary issue arises when substance use is primarily a response to an existing mental health condition, rather than being the original concern. In Janie's case, her bipolar disorder is the primary issue, influencing her relationship with alcohol, which serves as a means to cope with her sleep challenges. This highlights the complex interplay between mental health disorders and substance use, emphasizing that treatment approaches must address both domains to be effective.