Matthew Perry’s autopsy reveals ‘Friends’ star died from ketamine. What is ketamine?

LOS ANGELES – “Friends” star Matthew Perry died from the “acute effects of ketamine,” according to an autopsy report released by the Los Angeles County Medical Examiner‘s office.

As Emily’s Hope reported in late October, Perry was found unresponsive in a hot tub after battling substance use disorder for years.

While the autopsy identified the 54-year-old’s cause of death as the “acute effects of ketamine,” it also listed drowning, coronary artery disease, and the effects of buprenorphine as contributing factors. Buprenorphine is a medication used to treat opioid use disorder, as well as acute and chronic pain.

The autopsy disclosed that the level of ketamine, a “dissociative anesthetic,” in his system was as high as 3,540 nanograms per milliliter. The report noted that “levels for general anesthesia are typically in the 1,000-6,000 ng/ml ranges.”

Despite Perry’s reported ketamine infusion therapy for depression and anxiety, the autopsy suggested that the ketamine found in his system at the time of death could not be from that therapy, as ketamine’s half-life is 3 to 4 hours or less, and the method of intake remains unclear.

“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 report reads. “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 of the heart.”

Dr. Michael Bottros, chief of clinical operations and medical director for pain services with Keck Medicine of USC, told the Los Angeles Times that based on the autopsy findings, Perry may have taken ketamine orally, with the risk that “there was too much taken at once.” Bottros urged caution against dissuading people from ketamine treatment under medical supervision, emphasizing the importance of a balanced approach.

Ketamine, a controlled substance approved by the U.S. FDA for general anesthesia, has seen increased use, with a rise in clinics across the U.S. It is generally considered safe when administered by healthcare professionals, but recreational use carries risks of euphoria, dissociation, and at high doses, immobilization and hallucinations.

Tucker Avra, a UCLA medical student working with those recovering from ketamine addiction, told the Los Angeles Times that people using ketamine can also be at risk of passing out or falling down. “If you’re in water,” he said, there’s “a risk of drowning by basically putting yourself under anesthesia by using it.”

Avra urged people to avoid using the drug recreationally, but if you do, test for opioids, have Narcan on hand, and avoid using the drug alone.