Matthew Perry had talked about getting ketamine infusions in rehab and wrote that it was 'not for me' in his memoir before his tragic death.
In Friends, Lovers, and the Big Terrible Thing, the late Friends actor, who passed away at age 54, had opened up about undergoing ketamine infusion therapy when he was in rehab in Switzerland.
He said that it often made him feel like he was taking 'a giant exhale' but he would also sometimes feel like he was 'dying' when doing the therapy.
The beloved star — whose cause of death was revealed to be 'acute effects of ketamine' — had still been undergoing ketamine infusion therapy in the weeks leading up to his passing in late October.
He explained in his book that he was getting the treatments because the synthetic form of ketamine is used nowadays 'to ease pain and help with depression'.
Matthew Perry had talked about getting ketamine infusions in rehab and wrote that it was 'not for me' in his memoir before his tragic death
For that reason, he said it was like ketamine 'has my name written all over it' and 'they might as well have called it "Matty".'
In his book, he recalled undergoing the treatments in Switzerland for during the beginning of the pandemic.
'They'd bring me into a room, sit me down, put headphones on me so I could listen to music, blindfold me, and put an IV in,' he recalled in his book.
He had written that he would 'disassociate' as he listened to music during the infusions, adding that he 'often thought that I was dying during that hour.'
'Oh, I thought, this is what happens when you die,' he continued. 'Yet I would continually sign up for this s*** because it was something different, and anything different is good.'
'Taking K is like being hit in the head with a giant happy shovel. But the hangover was rough and outweighed the shovel,' he said, concluding that 'ketamine was not for me'.
At that same facility, Perry recalled a near-death experience when his heart stopped before he had to undergo a surgical procedure.
He said he would lie to doctors about experiencing stomach pain so they would give him medication.
In Friends, Lovers, and the Big Terrible Thing, the late Friends actor, who passed away at age 54, had opened up about undergoing ketamine infusion therapy when he was in rehab in Switzerland
He said that it often made him feel like he was taking 'a giant exhale' but he would also sometimes feel like he was 'dying' when doing the infusion therapy
'In fact, I was OK,' he admitted. 'It still felt like I was constantly doing a sit-up — so it was very uncomfortable — but it wasn't pain.
He said the doctors prescribed him hydrocodone and then later decided to 'put some kind of weird medical device in my back'.
He explained that inserting the device required surgery, but he was up all night taking hydrocodone the night before the procedure.
During the operation, he said his heart stopped after he was given propofol, an anesthetic and a sedative.
I was given the shot at 11:00 a.m.,' he recalled. 'I woke up eleven hours later in a different hospital.
'Apparently, the propofol had stopped my heart. For five minutes,' he continued. 'It wasn't a heart attack — I didn't flatline — but nothing had been beating.'
Perry's autopsy revealed he died from the 'acute effects of ketamine' and drowning - with the actor having similar quantities of ketamine in his system as a hospital patient under general anesthetic.
'The County of Los Angeles Department of Medical Examiner determined the cause of death for 54-year-old actor Matthew Langford Perry as the acute effects of ketamine,' the Los Angeles coroner's office said on Friday.
'Contributing factors in Mr. Perry's death include drowning, coronary artery disease, and the effects of buprenorphine (used to treat opioid use disorder). The manner of death is accident.'
Perry was found face-down in the hot tub which adjoins the swimming pool at his Los Angeles home at 4.17pm on October 28, stunning the world of showbiz and breaking the hearts of fans worldwide.
He had been receiving ketamine infusion therapy as treatment for depression, the medical examiner reported - but the last session was a week and a half before he died, and the ketamine is only in your system for three to four hours, which means it did not lead directly to his death.
'At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular overstimulation and respiratory depression,' the medical examiner, Raffi Djabourian, concluded.
In his last post to his Instagram, posted the week he died, the star shared images of him in his hot tub, which is next to his infinity pool
Perry's blood ketamine levels were at 3,540 ng/ml in peripheral blood, and 3,271 ng/ml in central blood.
For a patient under general anesthetic, in a hospital, a blood ketamine level of 1,000 - 6,000 ng/ml would be normal, the medical examiner explained.
'Drowning contributes due to the likelihood of submersion into the pool as he lapsed into unconsciousness; coronary artery disease contributes due to exacerbation of ketamine induced myocardial effects on the heart.
'Buphrenorphine effects are listed as contributory, even though not at toxic levels, due to the additive respiratory effects when present with high levels of ketamine.'
Police officers taped off the street leading to Matthew Perry's house where he was found dead on October 28
Matthew Perry died of the acute effects of ketamine combined with drowning, Los Angeles' coroners office has revealed
He had no alcohol, cocaine, heroin, meth or fentanyl in his system.
He was declared dead at the scene and the medical examiner conducted the autopsy on October 29.
Ketamine can be prescribed as a medical treatment, but it is unclear if the drugs in Perry's system were bought using a prescription.
The medical examiner said Perry had a history of emphysema, diabetes, and drug use - but he was 'reportedly clean for 19 months'.
He was described as a 'heavy tobacco user for many years but currently not smoking'.
The medical examiner also noted his ketamine infusion therapy.
A year before his death he released a tell-all memoir that included shocking details of his drug and alcohol addiction.
But he said in October 2022 that he was 18 months sober, though that was a year before his death.
Those who knew him maintain Perry was clean and sober at the time of his death.
When investigators responded to Perry's home, they did not find any illegal drugs, but found prescription medication that was properly labeled and kept in storage bottles.
WHAT IS KETAMINE?
Ketamine is a powerful general anesthetic that is used to stop humans and animals experiencing pain during operations.
It started being used as a party drug in the late 2000s, with people taking it before raves for a more intense experience.
It is used as an anesthetic, and has been in the national spotlight since the death of Colorado's Elijah McClain, who struggled with police and was injected by paramedics with a dosage appropriate for someone weighing 200 pounds. He weighed 143 pounds. Colorado is now trying to limit first responders' use of ketamine and other chemical restraints.
What are the side effects?
Ketamine causes a loss of feeling and paralysis of the muscles.
It can also lead to people experiencing hallucinations and a distortion of reality, which many call entering the 'k-hole'.
This is when people believe they have spoken to God or a higher power, which can lead to addiction as they crave that experience.
Ketamine may also cause people to feel incapable of moving, or lead to panic attacks, confusion and memory loss.
Regular users can seriously damage their bladders, which may need to be surgically removed.
Other risks include a raised heart rate and blood pressure.
Paralysis of the muscles can leave people vulnerable to hurting themselves, while not feeling pain properly can cause them to underestimate any damage.
Many claim ketamine withdrawal is worse than any other drug, with some feeling so depressed they contemplate suicide.
If you are having suicidal thoughts, contact the Samaritans here.
How is it taken and what is the law around it?
For medical use ketamine is liquid but the 'street' drug is normally a grainy, white powder.
In 1999, ketamine became a Schedule III non-narcotic substance under the Controlled Substances Act. It currently has accepted medical uses for short-term sedation and anesthesia.
In 2019, the FDA approved a version of the drug for treatment-resistant depression, which is only available at a doctor's office or a clinic.
Is illegal use of ketamine common?
In May 2023, a new report found that law enforcement agencies seized more than 1,500 pounds of ketamine in 2022 – about 12 times more than in 2017.
Tennessee, Florida and California had the most seizures of the drug. However, it's not clear whether those states have the highest usage.
Medical-grade ketamine is typically in a liquid form and is often administered through an IV.
But most of the illegally obtained ketamine was in a powder form, which means it risks being contaminated with other chemicals, in particular fentanyl.
How many people die from ketamine use?
Exact data is hard to come by: unlike with cocaine, heroin, or opioids the CDC does not publish the data on monthly and annual deaths.
The number is low, especially when compared to drugs such as fentanyl, which in 2022 killed almost 74,000 people.
Source: Talk to Frank, US Drug Enforcement Association
The medical examiner did find evidence of his years of drug and alcohol abuse, however, with Perry suffering from 'chronic hepatic congestion, liver' - a precursor to cirrhosis of the liver - although it had not advanced into cirrhosis.
He also had nephrosclerosis of the kidneys - a hardening of the tissues, caused by long-standing, poorly controlled high blood pressure and long term drug use.
Perry's autopsy also found chronic pancreatic fibrosis - opioids are suspected of causing damage to the pancreas.
His heart and lungs were also significantly damaged.
Perry weighed 216lbs, and was pronounced mildly obese.
In the memoir, Friends, Lovers and the Big Terrible Thing, Perry wrote that after his colon exploded in 2018, he was prescribed opiates that he deemed insufficient to deal with his pain.
This prompted him to turn to street dealers to supply him with potentially fatal, possibly fentanyl-laced OxyContin.
'The street pills were something like $75 per pill, so I was giving the guy $3,000 at a time, many times a week,' he wrote.
Perry wrote that he spent $9 million trying to get sober, going to 6,000 AA meetings, 15 times to rehab, and was in detox 65 times.
At his lowest, he was popping 55 Vicodin a day to fuel his addiction.
He said he overcame addiction in 2021 and was leading a healthier lifestyle.
He took up pickle ball - a game similar to tennis and table tennis - and usually played it twice a day, friends said.
Perry was found underwater by his assistant who lifted his head up to try to get him some air, first responders earlier revealed.
Captain Erik Scott, with the LAFD said: 'Los Angeles City Firefighters responded [and] found an adult male unconscious in a stand-alone hot tub.
'A bystander had brought the man's head above the water and gotten him to the edge, then firefighters removed him from the water upon their arrival.
'A rapid medical assessment, sadly, revealed the man was deceased prior to first responder arrival.'
Perry was laid to rest at an intimate ceremony at Forest Lawn Memorial Park in the Hollywood Hills attended by his Friends co-stars Jennifer Aniston, Matt LeBlanc, Lisa Kudrow, Courtney Cox, and David Schwimmer.
Perry wrote in his memoir that throughout his drug addiction and recovery he was helped by a female personal assistant he considered to be his rock and 'best friend'.
Morgan Moses, referred to in the book only by the pseudonym 'Erin', first met Perry when he was admitted to a rehab where she was working.
The pair subsequently struck up a friendship that would last nearly a decade and came to be the closest and most loving – though always platonic – relationship in his life.
Moses, 37, is a 'sober companion' whom the troubled Friends star described as 'the single nicest person in the world'.
On her LinkedIn page, Moses says she has worked 'full-time' as a 'sober companion' since 2018.
Among her skills listed are 'therapeutic crisis intervention', 'mental health first aid', 'behavioral intervention' and 'nutritional counselling'.
Originally a website designer, she is a graduate from Full Sail University in Florida, while her social media suggests she has also had her own addiction struggles and sobriety journey.