Statement by Phil Wolfson MD on Matthew Perry’s Unfortunate Demise

Phil Wolfson MD is one of the most prominent leaders in the ketamine and psychedelic healing world for decades. While crafting my own words to respond to this incident, he offered his guidance to the whole psychedelic assisted psychotherapy. All words past this point are his.

Dated 12/16/23

Matthew Perry died by drowning. Ketamine was found to be present at autopsy at high levels characterized as ‘anesthetic levels’.  Buprenorphine was also present, and he had significant coronary artery disease. He was open publicly about his long struggles with alcohol and drug dependence.  The presence of buprenorphine indicates he was under treatment for opioid dependence.

Apparently. Perry had been receiving intravenous ketamine treatment in a clinic and appeared to have stopped a month or so ago. The reasons for this are unclear. Ketamine has a more than two decade history for treating alcohol and drug dependence with some degree of success for some people. It is known to reduce the quantity of opioids needed for the same mental effect—a partial reduction. As with all treatments for dependency, continuation of treatment with and without ketamine is a necessity to prevent relapses.

Any sedating drug is incompatible with swimming and bathing. It is not related to whether it is ketamine, Xanax, Valium, or other substances that suppress consciousness.  Taking sedating drugs that produce sleep induction in water deep enough to drown in is a definite no-no.

Perry most likely had procured ketamine without a prescription as a powder and insufflated a great amount. An anesthetic level means simply that you are anesthetized and will not be able to deal consciously with circumstances. Ketamine takes a bit of time to have its effect—seconds to minutes—sufficient time to make a mistake and then subsequently become unconscious. Without much doubt Perry had obtained ketamine on the illegal market. Had he been prescribed lozenges from one of the many web distributors, he would have had to hold many lozenges for many minutes to have an effect, and  he would not have taken lozenges into the pool as his ability to breathe through his mouth would have been difficult.  And most likely, he would have had to lie down–and not in water. Had a legal prescriber provided the ketamine to Perry, it would have been both criminal and a gross malpractice.

Ketamine produces transient elevation of blood pressure, generally in the range of exercise elevations of heart rate and blood pressure. We do not know the condition of his coronary arteries and if ketamine’s transient effects contributed to his death. It is doubtful–and apparently, the autopsy did not reveal a myocardial infarction. It is also not clear what physical shape Perry was in and had he had a period of drug use that might have reduced his fitness.

This tragedy and others somewhat like it become lore that discredits the safety and profound potentiality of ketamine. All substances have abuse potential and are abused. Benzodiazepines (like Valium), antidepressants, sedatives, medicines used for  muscle relaxation, opiates, cocaine, meth, aspirin, acetaminophen, alcohol, psychedelics, etc. all have their aficionados and different forms of dependency and withdrawal—physical, psychological and spiritual. Ketamine has its own specificity. In clinical practice, ketamine dependency and abuse are rare.  Ketamine’s benefits are legion and mostly extraordinary. There is no benefit to ketamine bashing.  Sensationalism and misattribution only serve to perpetuate ignorance and repression.

The Conclusion is that Matthew Perry drowned, and he and we did not have sufficient capacities to help him with his demons. While it is not clear that he suicided, his action of taking ketamine as a substance known to him  for its effects raises the question for us—did he just have enough of life?

–Phil Wolfson MD  The Ketamine Papers, etc.

If you were interested in this blog post, check out some of these:

Ketamine for Psychotherapy? Yes!

Psychedlic Psychotherapy: A Novel Tool for Our Stuck Places (a video blog)