(NewsNation) — Matthew Perry’s autopsy report revealed his cause of death as “acute effects of ketamine,” but Dr. Drew Pinsky thinks the combination of drugs found in the late actor’s system tells a bigger story.
“It wasn’t just the ketamine,” Pinsky, a well known addiction specialist and host of “Ask Dr. Drew” said Monday on “CUOMO.” “It’s very important to understand here that he (Perry) was on buprenorphine, he was on two different benzodiazepines, which for a recovering addict is bizarre and ridiculous.”
The report determined Perry’s official cause of death to be from “the acute effects of ketamine” with contributing factors including drowning, coronary artery disease and buprenorphine effects.
Pinsky said in his professional opinion, it would be “out of the question” to have someone struggling with addiction on buprenorphine, benzodiazepines and ketamine at the same time.
“It’s wild, it’s dangerous, and for somebody with addiction, you see where it goes. It’s a terrible tragedy,” Pinsky said.
Dr. Tom Pitts, a board-certified neurologist, agreed the autopsy showed an inappropriate use of ketamine.
“Some people are prescribed home ketamine. I don’t know if he was prescribed it or if he got it illicitly, but he got into general anesthesia dosing that knocks you out, that tranquilizes you. Nobody would ever tell you to do that,” Pitts said during an interview on “Morning in America.”
According to the Los Angeles County autopsy report, toxicology testing revealed ketamine levels at 3,540 ng/ml and 3,271 ng/ml in Perry’s blood. For context, the medical examiner’s office said in a surgical setting, levels for general anesthesia are typically in the 1,000-6,000 ng/ml ranges.
The beloved “Friends” actor was reported to be receiving ketamine infusion therapy for depression and anxiety, but the medical examiner determined the ketamine found in his system at death could not be from his last known ketamine treatment a week and half before his death.
Ketamine is a dissociative anesthetic that has an advantage for medical professionals since it works rapidly and can keep patients conscious although dissociated from pain signals. It’s most commonly used in a surgical or emergency setting.
“It can be used as an anesthetic. More recently, we’ve noticed that at medium dosing, you can use it for pain. Then at lower dosing, you can have a transformative and healing space created for you,” Pitts said.
Pinsky said ketamine sometimes can be combined with psychotherapeutics or given as an at-home nasal spray in some cases as maintenance after initial infusions.
“It’s begun to be used for the treatment of recalcitrant depression. So if you have a depression that is not responding to anything else, it is reasonable to get some ketamine infusions,” Pinsky said.
Both doctors warn it’s not a medication to be used on its own without a medical professional’s guidance and expressed concerns about ketamine treatments for people who have struggled with addiction.
“He’s not your run-of-the-mill ketamine patient by any means. It can be done safely with the medical team surrounding you, not at home,” Pitts said.
Pinsky added: “I have seen it work, a course of six infusions of ketamine in a really serious case of depression. My concern is in people that have a history of addiction, I’ve seen it trigger a relapse. So, I’m not enthusiastic about it in the setting of addiction.”
Perry, 54, was found dead in a hot tub at his Pacific Palisades residence Oct. 28. The Los Angeles Fire Department said the actor was found unconscious in a hot tub by a bystander who had gotten Perry’s head above water while waiting for medical personnel to arrive. Once at the home, firefighters quickly pulled Perry from the water, but a rapid medical assessment revealed he died before first responders got there.
A deputy medical examiner completed Perry’s autopsy the following day.
Perry had been open about his struggles with addiction in the past, but his autopsy report says he was “reportedly clean for 19 months.”
Less than a week after Perry’s death, a foundation was established in his honor to help those dealing with addiction.