I started down the path of behavioral health before becoming a parish minister. I interned at the Wholistic Health Care Center of Hinsdale, Illinois, during the last year of my seminary career. I served as a pastoral counselor in a team that included physicians and nurses in a clinic that sought to treat medical and psychological issues together as part of an integrated approach. I was working toward my certification in the American Academy of Marriage and Family Counselors, and Pastoral Counseling was the focus of my doctoral paper. However, Dr. Granger Westberg, national chair of the Wholistic Health Care Centers, advised me that I would not yet have all the necessary qualifications upon graduation from the seminary. He urged me to get three or four years of pastoral experience before focusing on health care ministry as my career direction. I took his advice. I began serving as a pastor alongside my wife, a seminary graduate. We were ordained to the ministry. And I never looked back. The pastoral ministry fit my personality, skills, and energies well. I fell in love with the work and the people I was serving. It turned out to be the right decision for me.

I brought with me to the pastoral ministry skills and knowledge that I had acquired during my time in the Wholistic Health Care Centers. Although I referred persons needing specialized psychiatric care, I offered counsel to many parishioners. I became a suicide first responder and worked in the field of suicide prevention. I helped law enforcement officers deal with people who were suffering from acute mental health crises.

One of the classes I took in preparation for my work in counseling was an introduction to psychotropic medications. The course presented a broad introduction to both prescription and recreational drugs that were in everyday use at the time. I learned about the categories of drugs and some of their use. That class, however, was many years ago, and research has gone much farther. The range of available medications and their uses is far more vast and complicated than those I studied. I am not an expert, and I have not kept up.

I suspect, however, that I recognize the symptoms of drug use a bit more than the average person. I have read a lot of obituaries where the person died of suicide or drug overdose, and have learned to catch the code words that are used to hide the whole story. There is a lot of stigma attached to psychological disorders and death by suicide in our society, and people are motivated to cover up those issues.

One of the challenges that might be called a failure of our society is that we are not good at speaking directly about drug use and abuse. We tend to ignore and cover up issues that cause other problems by focusing our attention on those problems. When a person is homeless, we tend to blame rather than understand. Addiction can be a significant factor in many social issues, including homelessness, public disruptions, and violence. However, emergency treatment for acute mental health issues, including addiction, is difficult and expensive to obtain and is denied for many people.

Periodically, we get glimpses into issues of drug use and abuse, addiction, and a variety of other problems when a famous person becomes incapacitated or dies as a result of drug use. The death of Matthew Perry from an overdose has resulted in criminal charges. According to recent news releases, one of the doctors who supplied Perry with Ketamine will plead guilty in an attempt to reduce a possible 40-year sentence for his role in the death. It is an engaging public story in the light of public disclosures about the use and abuse of the same drug by Elon Musk, who has admitted to using not only Ketamine, but also psychedelic mushrooms and MDMA, also known as ecstasy. He also used the weight loss drug Ozempic, which can interact with other medications, especially hallucinogenic substances.

When people who are not famous or rich struggle with ketamine addiction, their loved ones might notice changes in behavior or physical symptoms, but they most often overlook these symptoms. Neglecting responsibilities sometimes is a presenting factor. However, a financial crisis is one of the significant indicators for family members. Ketamine is an expensive drug to maintain, and those addicted tend to place obtaining the drug over other financial obligations. Criminal activity to obtain funds for drug use is a common problem. Those symptoms can be overlooked for extended periods for the rich and powerful.

Perry and Musk aren’t the only high-profile individuals whose lives are altered by drug use. For the most part, the public is left to speculate because drug use and abuse in high-powered circles aren’t often reported.

As an observer, I wonder if there is more to the story when a famous person is admitted to the hospital for an uncommon reason. The CNN report that Homeland Security Secretary Kristi Noel was hospitalized for an allergic reaction yesterday caught my attention. Allergic reactions are usually to something. I doubt that her reaction was to a bee sting or pollen. It seems unlikely that she reacted to trying a new or unusual food. While I am not in a position to make a diagnosis, and she is entitled to some privacy about her health, her position in an administration that has a reputation for excessive drug use raises my eyebrows. Fortunately, she is receiving the treatment she needs.

Long days with lots of travel might make one turn to certain drugs to assist with alertness. Amphetamines work to make a person alert. They also boost confidence and energy in the short term. Those using those drugs become talkative, restless, and excited. Feelings of power and superiority are commonly associated with the use of that category of drugs. It would not surprise me if the allergy involved an accidental drug overdose.

However, it is unlikely that we will get the whole story. She may or may not have been using stimulants, and having to be rushed to the emergency room might have stemmed from a vast variety of health issues. Part of the reason we don’t know is that in our society, frank and honest talk about drug use and abuse is rare. It remains a hidden issue for most of the people who abuse drugs, especially those who are rich and powerful. We could hope that a brush with mortality might motivate someone to honesty and public disclosure, but I won’t be holding my breath. We’re likely to remain in the dark. It is a common experience for me. I often have found myself dealing with people without having the information on what makes them behave the way they do, and without a complete understanding of their problems and attempts at self-medication.

I wish the secretary health and hope she receives the treatment she needs. However, as we have found in other cases, doctors are not above simply prescribing more drugs to deal with the problems faced by their high-profile patients.