The cause of Matthew Perry’s passing has been made public.

The late actor from “Friends” passed away in October, but the Los Angeles County Medical Examiner’s office announced on Friday that it was an accident caused by “the acute effects of ketamine.” Contributing factors seemed coronary artery disease, sinking, and buprenorphine’s side effects.

“An opioid-like drug used for the treatment of opioid addiction and for acute and chronic agony,” according to acquisition of Perry’s 29-page autopsy report, is buprenorphine. According to the investigation, there were no signs of “fatal trauma while no foul play indicated.”

What caused Matthew Perry’s death?

According to his autopsy, Perry was discovered face-down and unconscious on October 28 in the “heated end” of his pool. In a statement to the Los Angeles Fire Department stated that upon arriving at Perry’s Pacific Palisades residence at 4:07 p.m. that day, they discovered “an adult male unresponsive in a stand-alone jacuzzi.”

When a bystander lifted his head above the water’s surface or led the man to its edge, firemen were able to save him from the depths. Sadly, a quick medical examination found the individual had passed away before first responders arrived, a LAFD spokesman, Nicholas Prange, told  in a statement on October 30.

According to his autopsy report, Perry returned from pickleball that afternoon, and his live-in personal assistant was the last person to see him alive. At 4 p.m., the assistant, who had been gone from Perry’s residence for many hours on errands, found him dead. At 4:17 p.m., the police declared him deceased.

His autopsy revealed that no narcotics, pills, or prescription substances had been discovered close to the pool. Alcohol and narcotics including heroin, cocaine, methamphetamine, and fentanyl were not present in his system.

“High levels of ketamine” and Matthew Perry’s demise

The autopsy, performed the day following Perry’s passing, characterizes him as a “54-year-old male with history of diabetes, emphysema, and chronic obstructive pulmonary disease; used drugs in past — reportedly clean for 19 months; heavy nicotine user for many years but not smoking; on ketamine in injections with most recent counseling reportedly two and a half weeks ahead of death.”

The report indicates that the medical examiner discovered 3,540 nanograms of ketamine, a “dissociative anesthetic,” in the patient’s system. Typically, general anesthesia levels are between 1,000 and 6,000 ng/ml.

Although Perry was “reported to be experiencing ketamine infusion therapy for depression and anxiety,” the study states that “the ketamine in his entire body at death could not be from that infusions therapy, since hydrochloride’s half-life is 3 to 4 hours, or less.” It’s unknown how the intake is done.

“At the high levels of ketamine discovered in his postmortem blood specimens, the main lethal effects would be from both circulatory overstimulation and respiratory depression,” according to the paper. “Drowning contributed due to the likelihood of submersion into the pool as he lapsed into unawareness; coronary artery disease contributes due to enhancement of ketamine induced myocardial effects of the heart.”

Another significant element mentioned is buprenorphine, which was present at “therapeutic” levels and had “additive respiratory effects when presented with high levels of ketamine.” There also existed non-toxic concentrations of lorazepam.

What consequences does ketamine have?

The U.S. Food and Drug Administration has authorized ketamine hydrochloride, sometimes known as ketamine, as a restricted drug for use in intravenous or intramuscular injections to induce and maintain general anesthesia. The FDA has not cleared it for use in mental health.

An October article on the FDA’s website states, “Because ketamine has not been approved for these uses, the FDA has not established safe or effective dosage of ketamine for any psychiatric indication.” “These variables may place patients at risk of serious adverse events, overuse, and abuse.”

Since it “distorted one’s experience of hearing and seeing, thus making individuals feel disengaged,” the United States bans it. Drug Enforcement Administration describes it as a dissociative anesthetic hallucinogen. The website of the Drug Enforcement Administration states that “an intoxication can cause sleepiness and significantly slowed breathing.”

In the 1970s, ketamine gained attention as a stimulant used by the counterculture. In the 2000s, it made a comeback as “Special K,” a club drug.

Dr. Nolan Williams, an associate professor in the Department of Psychiatry and Behavioral Sciences at Stanford University, has stated to USA TODAY that “many mechanisms happening at once” make it difficult to pinpoint the precise way in which ketamine influences mood.

However, studies on the effects of ketamine on the brain indicate that it targets a neurotransmitter called glutamate, which enhances the brain’s capacity to form enduring, novel lifestyle habits, as opposed to dopamine or serotonin.

Additionally, some experts have hypothesized that ketamine’s dissociative experience during a “trip” might be the reason for a decrease in depressive symptoms. Dr. Alexander Papp, an assistant clinical professor at UC San Diego and board-certified psychiatrist, says a few of his patients attribute their improved outlook on life to the psychedelic effects of ketamine, even though there’s no proof the experience actually influences mood.

Was Matthew Perry clean at the time?

Perry wrote candidly about his struggles with drugs and alcohol in his memoir “Friends, Lovers, and the Big Terrible Thing,” published in 2022. He expressed his commitment to carrying on battling an almost deadly illness in his writing with honesty and compassion.

According to Perry’s autopsy, “Alcohol, methamphetamine, cocaine, heroin, PCP, fentanyl hadn’t been detected” at the time of his death.

According to Jennifer Aniston, who spoke with Variety recently, Perry was leading a fulfilling personal life before to his passing.

“He was content. He was fit, according to Aniston. “He was no longer a smoker. He was getting fit. I only know that he was pleased. Funny Matty, I was really messaging him that morning. He didn’t feel any discomfort. He wasn’t having any difficulty.”