Matthew Perry, the “Friends” actor who publicly struggled with drinking and drug use for decades, died from the “acute effects” of ketamine, an anesthetic with psychedelic properties, the Los Angeles County medical examiner’s office said in an autopsy report that was released on Friday.
Perry was found unresponsive in a hot tub at his home in Los Angeles on Oct. 28. He was 54.
The medical examiner’s office said that drowning, coronary artery disease and the effects of an opioid, buprenorphine, had contributed to his death.
But the autopsy ascribed his death primarily to “the acute effects of ketamine.” Ketamine is a powerful anesthetic that has become increasingly popular as an alternative therapy for depression, anxiety, post-traumatic stress disorder and other hard-to-treat mental health problems. It is also used recreationally.
The autopsy report said that Perry had been on ketamine infusion therapy but that the ketamine in his system could not have been from his last known therapy session, which was about a week and a half before he died.
“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 autopsy report said. It noted that the level of ketamine investigators found in Perry’s blood was equivalent to the amount that would be used during general anesthesia.
The Food and Drug Administration issued an alert in October warning about the dangers of treating psychiatric disorders with compounded versions of the drug.
Toxicology tests also detected “therapeutic” levels of buprenorphine, a drug that medical examiners said was used to treat drug addiction and for pain; Perry’s live-in assistant said in a witness statement that he was seeing a psychiatrist and taking buprenorphine twice a day as prescribed. Investigators also found evidence of sedatives but found no evidence of alcohol, methamphetamine or cocaine.
Records unsealed as part of the autopsy report provided new details about the day Perry died.
Witnesses told detectives that Perry had played pickleball at 11 a.m. His assistant left the home to run errands around 1:37 p.m., and upon returning at 4 p.m. found him “floating face down,” records say. The assistant jumped in, moved Perry onto the steps, and called 911. Paramedics who responded pulled Perry out of the water and onto the grass before pronouncing him dead, records say.
Dr. Judy Melinek, a forensic pathologist unaffiliated with the investigation into Perry’s death, said in October that test results could take weeks because of a lack of qualified toxicologists, funding and equipment.
“It’s appropriate for it to take long,” Melinek said. “Sometimes it takes months to do a proper investigation.”
Perry did not shy away from speaking publicly about his struggles with drinking and drug use, which sometimes led to hospitalizations for a range of ailments. By his own account, Perry had spent more than half of his life in treatment and rehab facilities.
In his 2022 memoir, “Friends, Lovers and the Big Terrible Thing,” Perry shared in detail some of the health challenges he had faced over the years, including a series of medical episodes in 2018 that included pneumonia, an exploded colon, a brief stint on life support, two weeks in a coma, nine months with a colostomy bag and more than a half-dozen stomach surgeries.
Perry was just 24 when he was cast in “Friends,” a show that would forever change his life and one that would firmly plant his feet in the limelight. That sitcom ran for 10 seasons from 1994 to 2004, and eventually earned him and his co-stars $1 million per episode. During “Friends,” Perry starred in a number of movies, some of which failed to capture audiences at the box office, including “Almost Heroes” (1998) with Chris Farley, and “Three to Tango” (1999).
After Perry’s death, tributes from fans and friends washed over the internet, many remembering him for his acting talent, kindness and bravery in the face of his challenges. His fellow “Friends” actors said in a joint statement that they were “utterly devastated” by Perry’s sudden death. “We were more than just cast mates,” the statement said. “We are a family.”
A private funeral for Perry was held on Nov. 3, according to People. The magazine said a service was held at Forest Lawn Memorial Park, a cemetery where many of Hollywood’s biggest stars were buried, including Debbie Reynolds, Paul Walker and Bob Barker.
Orlando Mayorquin and Andrew Jacobs contributed reporting.
