Is Ketamine Dangerous? What we can learn from Matthew Perry’s death.

If you have been paying attention to the news lately, you have probably heard about Matthew Perry’s cause of death, listed as ‘acute effects of ketamine’. 

Unfortunately this pithy statement is greatly misleading and serves to demonize one of the safest, fastest-acting, and most effective treatments for depression and other mental health and addictive disorders available today. In fact, ketamine is listed as one of World Health Organization’s top 10 crucial drugs and has a long history of being a well-tolerated and effective medication. 

Mr. Perry’s blood levels revealed that he had 10 times the amount of ketamine than is typically clinically used to treat mental health conditions in both ketamine infusion and ketamine-assisted therapy centers. The amount of ketamine detected “would be enough to make him lose consciousness and lose his posture and his ability to keep himself above the water,” said Dr. Andrew Stolbach, a medical toxicologist with Johns Hopkins Medicine who reviewed the autopsy report at the request of The Associated Press. 

“Using sedative drugs in a pool or hot tub, especially when you’re alone, is extremely risky and, sadly, here it’s fatal,” said Stolbach, who noted that both ketamine and buprenorphine can be used safely." (The Seattle Times, December 2023)

Ketamine is a versatile substance that at lower doses can effectively treat depression and other mental health disorders, but at high doses is used for sedation and anesthesia. Mr. Perry’s autopsy showed that he had anesthetic levels of ketamine in his blood. Imagine getting into a hot tub as you undergo anesthesia, unsupervised. Sadly, you would almost definitely drown. 

Any substance has the potential for harmful use and abuse. Ketamine is no different. However, this in no way takes away from the effectiveness of the safe use of ketamine in a prescribed dosage range and in a controlled and supervised therapeutic setting. 

This tragedy reminds us that there is an increased risk in prescribing ketamine for unsupervised at-home use. But let's be clear – Mr. Perry illegally acquired the ketamine he used that led to his death. If a legal prescriber had prescribed the amount of ketamine found in Mr. Perry’s system for at-home use, this would be considered illegal and gross malpractice. 

So is ketamine dangerous? Well, I guess the answer would be yes and no. It completely depends on dosage and setting. Because ketamine is dissociative and has anesthetic effects at high dosage, it can make someone very vulnerable to danger when used above prescribed amounts and in unregulated settings such as hot tubs. However, when used in the prescribed dosage range in a controlled, directly supervised manner, such as in ketamine-assisted therapy, ketamine remains one of the safest and most effective tools in treating mental health conditions.

Unlike many, I wasn’t a huge fan of Friends and had no special affinity for Matthew Perry, but from what I know he seemed like a good-hearted guy who spent most of his adult life battling demons. I am saddened that his life was cut short by what appears to have been a deadly combination of high-dose ketamine taken while in water. 

If you have any questions about the safety of ketamine-assisted therapy, please reach out to us at Inner Path Wellness. We greatly believe in the therapeutic value of ketamine assisted therapy and are always available to discuss at no cost.