Matthew Perry, renowned for his role in "Friends" and publicly addressing his prolonged struggles with substance abuse, passed away at the age of 54. The Los Angeles County medical examiner's office, in an autopsy report released on Friday, identified the primary cause of Perry's death as the "acute effects" of ketamine, a potent anesthetic with psychedelic properties.
Perry was discovered unresponsive in a hot tub at his Los Angeles residence on October 28. The autopsy report listed additional factors contributing to his demise, including drowning, coronary artery disease, and the presence of the opioid buprenorphine in his system.
Despite undergoing ketamine infusion therapy, the autopsy ruled out the possibility that the ketamine detected in Perry's system originated from his last known therapy session, which occurred about a week and a half before his death.
The report emphasized that the elevated levels of ketamine found in Perry's postmortem blood could result in cardiovascular overstimulation and respiratory depression. The concentration of ketamine was noted to be equivalent to that used in general anesthesia. Despite ketamine's growing use as an alternative therapy for mental health conditions, it is also known to be used recreationally.
In October, the Food and Drug Administration issued a warning alerting the public to the hazards of using compounded versions of drugs for treating psychiatric disorders. Additionally, toxicology tests revealed the presence of "therapeutic" levels of buprenorphine, a drug commonly prescribed for drug addiction and pain management. Perry's live-in assistant stated in a witness statement that Perry was under the care of a psychiatrist and took buprenorphine as prescribed twice a day. Although investigators found evidence of sedatives, there was no indication of alcohol, methamphetamine, or cocaine in his system.
Details surrounding the day of Perry's death were disclosed in unsealed records from the autopsy report. Witnesses informed detectives that Perry had engaged in pickleball at 11 a.m. His assistant left the residence for errands around 1:37 p.m. and returned at 4 p.m. to discover Perry "floating face down." The assistant promptly called 911 moved Perry onto the steps, and initiated CPR. Despite paramedics' efforts, Perry was pronounced dead after being pulled from the water.
Dr. Judy Melinek, an independent forensic pathologist, commented in October that delays in test results were expected due to a shortage of qualified toxicologists, funding constraints, and equipment availability. Emphasizing the necessity of a thorough investigation, Melinek noted that such processes could take months.
Matthew Perry, openly discussing his struggles with substance abuse, faced hospitalizations for various health issues over the years. In his 2022 memoir, "Friends, Lovers and the Big Terrible Thing," Perry detailed health challenges, including a series of medical episodes in 2018 that involved pneumonia, an exploded colon, a period on life support, two weeks in a coma, nine months with a colostomy bag, and multiple stomach surgeries.
Perry catapulted to fame at the age of 24 with the iconic role in "Friends," experienced a successful run during the show's 10 seasons from 1994 to 2004. Following the sitcom, Perry appeared in several films, though not all achieved box-office success. Tributes poured in from fans and colleagues after his death, with fellow "Friends" actors expressing devastation and highlighting their bond as a family beyond being cast mates.
What is Ketamine?
Ketamine is categorized as a dissociative anesthetic hallucinogen, inducing a sense of detachment from pain and surroundings while distorting perceptions of sights and sounds.
Approved as a short-acting anesthetic for both humans and animals, ketamine is also employed off-label to manage post-surgical and acute pain. Dr. Amber Borucki, an associate professor of anesthesiology, perioperative, and pain medicine at Stanford University, and a member of the Pain Committee for the California Society of Anesthesiologists, notes its use in hospitals typically involves low-dose IV infusions.
A specific variant of ketamine known as esketamine, or S-ketamine, is sanctioned as a nasal spray for treating treatment-resistant depression in adults.
Is Recreational Ketamine Hazardous?
According to Sivakumar, instances of overdoses and fatalities associated with ketamine are predominantly linked to recreational use rather than clinical applications.
Recreational ketamine, often ingested as a powder or liquid, may be combined with substances such as MDMA (ecstasy), amphetamine, methamphetamine, and cocaine. While the side effects observed in clinical settings may also manifest in recreational use, higher doses can exacerbate their severity.
Sivakumar warns that elevated ketamine doses can lead to neurological, gastrointestinal, and potentially cardiovascular or respiratory toxicity. Symptoms of a ketamine overdose encompass loss of consciousness, dangerously slow breathing, and heart-related issues like a slow heart rate or even a heart attack.
Prolonged recreational ketamine use may result in enduring psychiatric effects, including depression, impaired memory, and concentration. Further complications of extended use may involve bladder problems, abdominal and pelvic pain, blood in the urine, and potential liver issues.
Seeking Assistance for Substance Addiction
In addition to various adverse effects, ketamine "poses a risk for [misuse], and the potential to cause severe psychological and/or physical dependence," as emphasized by Borucki.
Recognizing when your usage of this substance might be evolving into a substance use disorder involves being attentive to certain indicators:
1. Inability to Curtail Use: Persistent difficulty in slowing down or discontinuing use, even after making repeated attempts to quit.
2. Compulsive Urges: Experiencing compelling and uncontrollable urges to use the drug.
3. Neglecting Relationships: Failing to prioritize family, work, or other relationships due to drug use.
4. Persistent Use Despite Harm: Continuing to use the drug despite being aware of its detrimental impact on your health and overall life.
5. Increased Tolerance: Requiring higher doses of the drug to achieve the same desired effect.
6. Withdrawal Symptoms: Encountering painful physical or psychological withdrawal symptoms when attempting to cease usage.
Recognizing these signs is crucial in taking the first steps toward seeking assistance and addressing potential substance addiction issues.
Bottom Line
Matthew Perry's tragic passing highlights the profound challenges of addiction, specifically the alarming impact of ketamine misuse. As we reflect on Perry's public struggles and the autopsy's revelations, it becomes evident that substance misuse is a complex issue with potentially severe consequences. The article not only commemorates Perry's legacy but also underscores the critical need for awareness about the risks associated with recreational ketamine use and the importance of recognizing signs of substance use disorder. Perry's story serves as a poignant reminder of the ongoing battle against addiction, urging society to prioritize mental health conversations and seek help for those in need.
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