Ketamine, a powerful anaesthetic and hallucinogen, has been found to be the cause of death of the popular actor Matthew Perry, who was best known for his role as Chandler Bing in the sitcom Friends. Perry, who had a history of substance abuse and mental health issues, was found unresponsive in a hot tub at his home in Los Angeles on October 28. He was 54 years old.

What is ketamine and how is it used?

Ketamine is a drug that was first developed in the 1960s as an anaesthetic for animals and humans. It is listed as a hallucinogen by the US Drug Enforcement Administration, as it can create a feeling of detachment from pain and the environment. Some users experience pleasant visualisations, while others may enter a state of dissociation known as the “k-hole”.

In recent years, ketamine has gained popularity as a treatment for depression and other serious mental health conditions, especially for those who do not respond to conventional therapies. Ketamine is believed to affect brain receptors that are not targeted by traditional antidepressants, and to have a rapid and lasting effect on mood and cognition.

However, ketamine is also used as a recreational drug, often by club goers who snort, inject or smoke the white crystalline powder. Ketamine can cause serious side effects, such as slowed breathing, increased blood pressure, nausea, vomiting, confusion, memory loss, bladder damage and cognitive impairment. Ketamine can also be addictive and lead to dependence and withdrawal symptoms.

Why was Matthew Perry taking ketamine?

According to the Los Angeles County medical examiner’s office, Perry died from the “acute effects” of ketamine, and drowning, coronary artery disease and the effects of an opioid, buprenorphine, had contributed to his death. No foul play is suspected, and no drugs were reportedly found on the scene.

Perry had a long and public struggle with addiction and mental health problems, dating back to his days on Friends. He had admitted to abusing alcohol, opioids, cocaine and other substances, and had undergone several stints in rehab. He had also suffered from pancreatitis, gastrointestinal perforation and multiple surgeries.

Perry had revealed in his 2022 memoir, Could I Be Any More Honest?, that he had tried ketamine as a treatment for his depression and anxiety, but had a negative reaction to the drug. He wrote that ketamine made him feel like he was “dying” and that he had “no control over anything”. He also said that he had stopped taking the drug after a few sessions, as he did not want to risk becoming addicted to it.

What is the debate around ketamine?

Ketamine is a controversial drug, as it has both potential benefits and risks for people with mental health issues. Some experts and patients have praised ketamine as a lifesaving and transformative treatment, while others have warned of its dangers and lack of regulation.

Ketamine is not approved by the US Food and Drug Administration for treating depression, but it is legally prescribed off-label by some doctors and clinics. There is also a growing market for illegal and unlicensed ketamine providers, who may offer the drug in unsafe and unhygienic conditions.

There is also a lack of research on the long-term effects and safety of ketamine treatment, as most studies have been small, short-term and conducted in controlled settings. There is no clear consensus on the optimal dose, frequency, duration and mode of administration of ketamine, and how to monitor and prevent adverse outcomes.

Ketamine remains a divisive and debated drug, as it poses both hope and harm for people with mental health challenges.