Does Matthew Perry’s Death Mean Ketamine Therapy Isn’t Safe?

 

Matthew Perry’s death is officially attributed to “the acute effects of ketamine,” but that’s like saying someone died from falling asleep rather than from the house fire that raged around them—technically true, but it misses the point of what actually went wrong.

Perry drowned. The ketamine didn’t stop his heart, didn’t cut off his air—it altered his awareness, leaving him susceptible to drowning. Any drug expert would tell you he’d still be alive if he’d been sitting on his couch instead of a hot tub.

If we want to understand what led to his death, we have to begin with a crucial question:

Consider this table:

Discussion:

1. Matthew Perry Was Undergoing Medically-Supervised Ketamine Therapy At the Time of His Death

He was undergoing therapy with ketamine in a clinic to help with severe depression and anxiety. The staggering amount of ketamine found in his system was far beyond anything prescribed in a therapeutic setting.

Law enforcement made one thing clear: the ketamine found in his body didn’t come from supervised treatments. Perry wasn’t overdosing on a prescribed regimen. The ketamine that killed him came from somewhere else.

2. Matthew Perry Wanted Higher Doses—His Doctors Refused

He pushed for higher doses of ketamine. His doctors refused—the risks were too great. But the denial didn’t stop him. It sent him looking for illicit sources. 

3. The Ketamine That Killed Matthew Perry Didn’t Come From His Doctors

Authorities zeroed in on a network supplying illicit ketamine to Hollywood’s elite—a tangled web of underground providers, shady prescriptions, and high-profile enablers.

At the center? The so-called ‘Ketamine Queen,’ a Beverly Hills woman who bragged about supplying ketamine to celebrities off the books. She wasn’t a doctor, but she had connections to those who were willing to look the other way.

4. Perry’s Medically Supervised Dose Followed Established Protocols

The most common dose for intravenous (IV) ketamine in the treatment of depression, particularly for treatment-resistant depression, is 0.5 mg/kg. It can go up to 0.75 mg/kg for patients who do not respond to the standard dose. 

• As an 186 lbs man, I took about 50 mg of ketamine per medically-supervised session. 
• As a 216 lbs man, Perry probably took about about 73 mg per session (assuming doctors gave him the higher 0.75 mg/kg dose). 

5. Perry’s Ketamine Levels Were Meant for the Operating Room, Not a Therapy Session

Perry’s autopsy did not specify the exact milligram count, but it confirmed a critical fact: the ketamine in his system fell within the established range for general anesthesia. This is a precise and recognized benchmark in medical dosing, not an ambiguous statement. The standard dosage for surgical anesthesia is 9 to 13 mg per kilogram of body weight—a staggering 800% to 1,200% increase over the therapeutic dose used in depression treatment.

6. There Was No Waking Up From That Amount of Ketamine

At these levels, ketamine doesn’t just alter perception—it induces deep unconsciousness, shutting down awareness and eliminating the body’s ability to respond to danger, including the inability to breathe if submerged underwater.

To understand the role ketamine played in Perry’s death, we need to look at its risks—and how they compare to other substances. The truth is, death from ketamine alone is extremely rare, especially in controlled, medical contexts. It is almost impossible to find examples of ketamine singularly causing the type of respiratory failure and cardiac arrest that opioids (fentanyl, heroin, oxycodone), depressants (Xanax, Valium), or barbiturates like phenobarbital are known to cause.

Even the DEA classifies it as a Schedule III drug, indicating a low to moderate potential for dependence—nothing like the iron grip of heroin, crack cocaine, or methamphetamine. Unlike many drugs, ketamine doesn’t even appear on top 10 lists of the most addictive substances.

Ketamine in Context: Comparing Emergency Room Visits

If ketamine were as dangerous as some claim, we’d see a massive number of overdose cases in hospitals. But that’s not what the data shows. Consider emergency department visits in 2011 (the most recent year with isolated ketamine data):

• Ketamine: 1,500 Emergency Department Visits
• Alcohol: 606,653
• Cocaine: 505,224
• Marijuana: 455,668
• Heroin: 258,482
• Pain relievers: 546,612
• Benzodiazepines: 284,875

The contrast is stark. Even recreational ketamine use rarely leads to overdose deaths when ketamine is used alone. Most recorded ketamine-related fatalities involve polydrug use, particularly when combined with depressants like alcohol or opioids. Perry’s autopsy revealed therapeutic levels of buprenorphine, a depressant used to treat opioid addiction, in his system. This raises a crucial point: ketamine’s risk profile changes dramatically when mixed with other substances.

How strong is ketamine’s hold, and how severe is the withdrawal? Unlike opioids, alcohol, or benzodiazepines, ketamine doesn’t produce intense physical withdrawal symptoms. It’s easy to stop ketamine cold turkey—no shaking, no sweating, no physical agony that comes with withdrawals from harder substances.

That doesn’t mean ketamine is risk-free. Its potential danger leans more toward psychological dependence than physical addiction. People who use ketamine outside of medical settings often chase the dissociative effects, looking to escape reality or numb emotional pain.

It’s quick, it’s intense, and it doesn’t last long—perfect for party scenes or for those trying to outrun their feelings. Regular use can lead to tolerance, which means needing more to feel the same, and that’s when the cycle tightens its grip. Still, you’d likely need to use ketamine two to three times a week, over an extended period, to build significant tolerance.

Now, the way a drug is taken can ramp up its risks. Smoking, injecting, or snorting can amplify dangers for substances like heroin or cocaine. Ketamine, on the other hand, is rarely injected outside of medical settings, minimizing risks of infections or overdoses related to poor administration. In clinics, professionals follow strict protocols to ensure safe dosages and administration.

A New Moral Panic?

And yet, despite all this data, Perry’s death is poised to become the rallying cry for those looking to push ketamine back into the shadows. The nonstop media coverage of the trial of Jasveen Sangha—the “Ketamine Queen”—and Dr. Salvador Plasencia will likely sideline the thousands who have found relief through responsible use, in favor of a narrative that paints ketamine as a villain.

We’ve seen this before: in the 1960s, psychedelics showed incredible promise until sensationalized headlines about “acid casualties” and “bad trips” triggered a moral panic, leading to the Controlled Substances Act of 1970. That decision set back psychedelic research for decades.

Now, history threatens to repeat itself. The FDA, already hesitant about psychedelic treatments, could face mounting pressure to ban or severely restrict ketamine’s use for depression and anxiety. The DEA might consider reclassifying it as a Schedule I drug, wiping out the progress made in psychedelic-assisted therapy. And most concerning of all, people battling depression could be scared away from ketamine therapy, depriving them of a potential lifeline.

Ketamine Saves Lives—Will We Let Fear Destroy That?

Ketamine is one of the few treatments capable of rapidly relieving severe depression, even in cases where traditional antidepressants fail. Its effectiveness in treating PTSD and suicidal ideation is well-documented, making it a critical tool in the fight against mental illness.

But if knee-jerk reactions to Perry’s death push ketamine therapy out of reach, it won’t be just celebrities making headlines—it will be everyday people losing access to life-saving treatment.

Matthew Perry’s death is not a cautionary tale of a dangerous drug; it’s a scathing indictment of a broken system. He died because of a web of negligence, cruelty, and contempt from those who saw his suffering as an opportunity to profit.

His death is a damning account of the greedy doctors who belittled him, the drug suppliers who enabled him, and the treatment centers that failed him time and time again. Perry was failed at every level by people who should have known better, and in the end, it was their greed and indifference that drowned him as much as the water in that hot tub.

The tragedy is already immense, but it could get worse. If his death becomes the catalyst for a sweeping crackdown on ketamine, it won’t just be Perry who suffered at the hands of a system that failed him—it will be the countless people who need this treatment to fight their own battles with depression. The media will latch onto every salacious detail of the upcoming trial, creating a wave of panic that could push ketamine therapy to the brink of extinction.

In the end, the real question isn’t whether ketamine is dangerous—it’s whether we’re about to let fear and sensationalism drown a treatment that has saved so many lives.