Matthew Perry toxicology report reveals cause of death was "acute effects of ketamine"

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Matthew Perry, the beloved "Friends" sitcom star, died from the "acute effects of ketamine," according to an autopsy report released Friday by the Los Angeles County medical examiner. 

Perry, 54, was found unresponsive at his home on Oct. 28 "floating face down in the heated end" of the pool, the autopsy report said. The report says the death was accidental and that no signs of foul play were suspected. His cause of death is listed as the "acute effects of ketamine," with contributing factors listed as "drowning, coronary artery disease and buprenorphine effects." (Buprenorphine is a medication used to treat opioid use disorder.)

The actor had gone out to play pickleball around 11 a.m. the morning of his death and returned home two hours later, witnesses told police in reports that were included with the autopsy. His assistant had gone out to run errands shortly afterward — the last time Perry was seen alive — and upon return found the actor dead, the report said. Police pronounced him dead at 4:17 p.m., the report said. 

Just over an hour after midnight on Oct. 29, Perry was transported from his house to the Forensic Science Center. Perry's autopsy was performed later that day.  

Perry struggled with addiction for many years, although he reportedly had been clean for 19 months, the autopsy report said. Perry had been receiving ketamine infusion therapy for depression and anxiety, with the last treatment a week and a half before his death, the autopsy report said. Perry had been responding to treatment and was "in good spirits," police said a witness told them in their incident report. 

Ketamine has been approved by the FDA as an anesthetic since the 1970s, and research shows it may help some patients when used as a medically-supervised treatment for depression and anxiety. Experts say it also has risks. The drug has a dissociative effect, seemingly separating the mind from the body, and can cause hallucinations. It is known for its use in nightclub and party culture. The federal Drug Enforcement Agency warns that an overdose of ketamine can cause unconsciousness and dangerously slowed breathing.

Trace amounts of ketamine were found in Perry's stomach, but the coroner said high levels of the drug were found in his blood: 3.54 micrograms per milliliter. These levels led the Medical Examiner's Office to conclude that Perry's cause of death was not from his prior infusion therapy —the drug's half-life is just 3 to 4 hours— but rather ketamine that was taken in another manner. How that happened, the autopsy report said, is unknown. 

Perry rose to fame with his role as Chandler Bing on "Friends," known for his eccentric mannerisms and quirky personality. He quickly became a fan favorite on the show, which aired for 10 seasons from 1994 until 2004. 

Perry wrote about his addiction in a memoir released last year, "Friends, Lovers and the Big Terrible Thing," detailing his years of struggling to stay sober. He told CBS News in 2015 that "people don't understand that it's a disease," and that those with addiction should "get the help" and not blame themselves.

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