Clinical Relevance: even patients with privileged backgrounds may abuse drugs and alcohol

  • Shortly before his death, actor Matthew Perry wrote a book detailing a lifelong struggle with addiction.
  • The Friend’s star had been a substance abuser ever since taking his first drink at age 14.
  • His opioid addiction led to several life-threatening episodes.
  • Many of the 3 million Americans with opioid use disorder never received the level of help Perry did. 

An unfortunate update on the death of Friend’s actor, Matthew Perry. A just-released coroner’s report revealed that the 54-year-old passed away due to the acute effects of ketamine.

According to the Los Angeles County medical examiner’s autopsy report, Perry’s death was accidental, with drowning, coronary artery disease, and buprenorphine effects listed as contributing factors. Perry, found unresponsive in his pool on October 28th, 2023. His assistant said that he had played pickleball earlier in the day before she had last seen him alive. The high levels of ketamine in his blood suggested recent intake, the report said. This finding did not linked to his prior infusion therapy for depression.

Ketamine, an FDA-approved anesthetic, is noted for its dissociative effects and risks of overdose. Despite its therapeutic use in controlled settings for treating depression and anxiety, unsupervised or recreational use carries significant risks, including potentially lethal overdose due to respiratory depression.

A History of Substance Abuse

Actor Matthew Perry said he was among the 3 million Americans who live with opioid use disorder. He revealed the details of his addiction in his book, Friends, Lovers and the Big Terrible Thing (Flatiron Books) 

The book chronicled his decades-long addiction to substances including Vicodin, Xanax and OxyContin. After having his first drink at age 14, his constant opioid overuse resulted in several life-threatening situations.

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The Friends star wrote about a time that he almost died at age 49 after his colon exploded from opioid use.  He was in a coma and on life support for two weeks after the incident, then spent five months in the hospital and used a colostomy bag for another 9 months, he recalled.

“I had been on opiates, and off opiates, and back on different opiates for so long that I suffered from a situation that only a subset of the population gets,” Perry writes, adding that he underwent 14 follow-up surgeries after the initial seven-hour emergency procedure.

The experience “miraculously removed my desire to take drugs,” he wrote.

However, he was at it again in 2020. This time he admitted to faking symptoms while staying at a Swiss-based treatment center so doctors would prescribe hydrocodone. That lie almost cost him his life, he writes. When the drug mixed with the propofol he was prescribed before surgery, it stopped his heart. 

“I was given the shot at eleven a.m.,” Perry wrote. “I woke up 11 hours later in a different hospital. Apparently, the propofol had stopped my heart. For five minutes.” 

“I have been to six thousand AA meetings. (Not an exaggeration, more an educated guess.) I’ve been  to rehab fifteen times. I’ve been in a mental institution, gone to therapy twice a week for thirty years, been to death’s door,” he wrote. He claimed that at age 53, he had been sober for more than 18 months. The autopsy results seemed to suggest otherwise.

High Cost of Addiction

Throughout his career, Perry said that addiction strained his relationships and cost him acting roles. But he credited his starring role on the popular sitcom for keeping him alive. Without the show,   – and his costars’ support – he speculated that he might have wound up on the street shooting heroin into his arm. He also acknowledged his privilege, noting that over the years he had spent more than $7 million trying to control his addiction.

Many Americans aren’t as fortunate. According to the Center for Disease Control and Prevention, overdoses are the number one cause of accidental death – and the third largest cause of death overall – in the U.S. There were over 107,000 fatal overdoses in the U.S. in 2021 which, according to CDC statistics, is the highest number of overdose deaths ever recorded in a single year. Overdose deaths involving synthetic opioids such as fentanyl, psychostimulants such as methamphetamine, and cocaine all increased between 2020 and 2021.

Intensive addiction treatment like the kind Perry received is hard to access and rarely covered by insurance. Only 10 percent of people who need treatment ever receive it.

Perry’s book is currently on sale wherever books are sold.