Matthew Perry's fatal ketamine dose is subject of criminal probe - Los Angeles Times

Matthew Perry’s death from acute effects of the prescription drug ketamine is the source of a criminal investigation, with authorities examining where the actor got the medication, LAPD officials told The Times.

Perry was found dead Oct. 28 in the hot tub of his swimming pool at his Pacific Palisades home. Trace amounts of ketamine — which is sometimes used to treat depression — were found in Perry’s stomach, according to the Los Angeles County medical examiner. But the level found in his blood was about the same quantity as would be used during general anesthesia, his autopsy showed.

How Perry came to have so much ketamine is now the subject of a probe by the Los Angeles Police Department with the assistance of the Drug Enforcement Administration and the U.S. Postal Service, Robbery-Homicide Division Capt. Scot Williams told The Times on Tuesday. TMZ first reported the investigation.

The ketamine in Perry’s system caused cardiovascular overstimulation and respiratory depression, the medical examiner reported. Other contributing factors in the actor’s death included drowning, coronary artery disease and the effects of buprenorphine, a medication used to treat opioid-use disorder.

The actor was best known for playing the sarcastic and witty Chandler Bing on NBC’s “Friends” for 10 seasons, from 1994 to 2004. In his 2022 memoir, Perry said he began abusing substances at the age of 14 and landed the role on “Friends” a decade later. Fame increased his dependency on alcohol and drugs. At one point, he said in his book, he took nearly five dozen pills a day.

According to the medical examiner, Perry was undergoing ketamine infusion therapy every other day for a period of time but had reduced that intake, and his last known infusion was a week and a half before his death.

The medical examiner said the ketamine found in Perry’s system at the time of his death could not have been from that earlier infusion as it typically disappears in detectable amounts in three to four hours after intake.

According to his autopsy report, Perry had been playing pickleball about 11 that morning, and his live-in assistant last saw him at 1:37 p.m.

Upon returning to Perry’s home on Blue Sail Drive, the assistant found him floating face-down. The assistant jumped in, pulled Perry’s head out of the water and called 911.

Paramedics arrived and moved Perry onto the grass, where he was pronounced dead.

A legal medication commonly used as an anesthetic, ketamine has been increasingly offered “off label” at private clinics to treat depression and other mental health disorders, according to Dr. David Goodman-Meza, an addiction-medicine and infectious-disease specialist at UCLA.

Some people also snort or inject it recreationally to experience euphoric or “dissociative” effects that cause someone to feel separated from their own body, Goodman-Meza told The Times in December. At very high doses, it can make people feel immobilized and spur hallucinations, an experience called a “K-hole.”

The drug can complicate breathing and increase demands on the heart. If someone already has coronary artery disease and is taking high doses of ketamine, “that could then speed up your heart, create more demand, but then your arteries don’t have the ability to supply that demand,” the physician explained.

The autopsy report noted that Perry had no other drugs in his system and had been 19 months sober at the time of his death. There was no evidence of illicit drugs or paraphernalia at his home.

The medical examiner also noted that Perry, 54, had diabetes and suffered from chronic obstructive pulmonary disease, which refers to a group of diseases that cause airflow blockage and breathing-related problems. He at one time had a two-pack-a-day cigarette habit.

A coroner’s investigator interviewed a person close to Perry who described him as in “good spirits” and said he had quit smoking two weeks prior to his death and was weaning himself off ketamine.

In 2006, the National Institute of Mental Health concluded that an intravenous dose of ketamine had rapid antidepressant effects. About 300 clinical trials have been held, and they have broadly found that ketamine is extremely fast-acting compared with traditional antidepressants and can relieve depression for a period that can last days or weeks.

Times staff writer Emily Alpert Reyes contributed to this report.