What is ketamine? A doctor explains the drug involved in Matthew Perry's death
More than a month after comedic actor Matthew Perry's unexpected death, the Los Angeles Medical Examiner's Office has released an autopsy report attributing his passing to an overdose of ketamine.
Perry, 54, was found unresponsive in his pool on on Oct. 28, "floating face down in the heated end," the report states. Contributing factors included drowning, coronary artery disease, and the presence of buprenorphine, a medication used to treat opioid addiction.
What is ketamine? The United States Drug Enforcement Administration lists ketamine as a hallucinogen. It is referred to as a "dissociative anesthetic hallucinogen" because it creates a feeling of detachment from pain and the environment.
Ketamine got its start as an anesthesia medicine for animals in the 1960s. The FDA approved it as an anesthetic for humans in 1970, according to WebMD.
Angelique Campen, an emergency room doctor of at Providence St. Joseph Medical Center, explains how the drug led to the actor's death.
"This was probably the perfect storm of combinations that may have led to his death," Campen said. "We use ketamine frequently in the emergency department as an anesthetic because of its safety profile. There are now uses of ketamine for depression given in clinics. Typically it doesn't stop your breathing like opioids and other anesthetics would. ... It has an excellent safety profile, of course with any drug it needs to be given under medical supervision especially an anesthetic."
However, Campen says the drug can be "very dangerous" when used recreationally.
Commonly known by the street names "special K" or "vitamin K," the drug can be both injected or used in its powder form, in which case it is snorted, smoked, or mixed into drinks.
Ketamine can cause what doctors call a "dissociative experience" and what recreational users call a "trip," traditionally lasting about two hours, according to WebMD.
Campen says that this is likely what happened to Perry, causing him to slip into a "trance state" while he was in the water.
"What I foresee happened with him is, what it does is put you in kind of a trance state, so he probably was in the hot tub in a trance state, slipped under the water and drowned," she said. "So, the ketamine in and of itself doesn't stop your breathing, but it can keep you from waking up if you are submerged."
Recently, ketamine has been used more widely due to its clinical treatment for some cases of major depression. Harvard Health reported that if a person responds to ketamine treatments, it can rapidly reduce suicidal thoughts and can be effective for treating depression combined with anxiety.
Campen suggests that Perry likely took the wrong dosage of ketamine before getting into the pool.
"Ketamine is not used outside of the supervision of a medical professional. So, if it was in his system at those doses, because it has a very short half life ... it would have been out of his system within 2 to 3 hours. He was using it recreationally. Unfortunately it was the perfect storm in a hot tub."
Ketamine IV infusions are only administered in the doctor's office. They are limited and timed, with most treatments lasting six weeks. WebMD reports the IV infusion lasts about 40 minutes, with the dissociative experience kicking in immediately and lasting for about 15 minutes after the drip ends.
"I think this is an isolated, outlying incident. We see plenty of people that use ketamine and lots of other drugs that are good drugs that we use in a hospital — they abuse it on the street and it doesn't take away from the safety profile of it in a hospital, under medical supervision," Campen said.
