Update: 5 arrested, including 2 doctors, in connection with Matthew Perry's death

Following Matthew Perry’s death in October 2023, an autopsy report revealed the acute effects of ketamine as the primary cause of death of the “Friends” star. Drowning and other medical issues were listed as contributing factors. Although Perry had been receiving ketamine treatments for depression and anxiety, the amount he had taken was “in amounts not nearly enough to account for his death.”^[]

Five arrests

The two lead defendants in the case are Jasveen Sangha, who is accused of selling Perry the ketamine that led to his death, as well as Dr. Salvador Plasencia, a licensed medical doctor accused of distributing around 20 vials of ketamine to Perry.^[] Three additional defendants were separately charged, including:

• Erik Fleming, who admitted to distributing upwards of 50 vials of ketamine to Perry and has pled guilty;

• Dr. Mark Chavez, who worked to obtain ketamine and has agreed to plead guilty; and

• Kenneth Iwamasa, Perry’s live-in assistant, who received the deliveries of ketamine for Perry and has pled guilty.

Ketamine: Medicinal benefits and recreational risks

Ketamine can be used safely in some anesthesia and mental health treatments, but uncontrolled use or overuse can be dangerous. For medical anesthesia or mental health purposes, ketamine tends to be given as an infusion. Perry received a monitored ketamine infusion about a week before his death. Given the time between the treatment and the incident, however, doctors say that the infusion does not explain the ketamine levels revealed by the autopsy. 

Walavan Sivakumar, MD, a board-certified neurosurgeon and Director of Neurovascular Surgery at Pacific Neuroscience Institute-South Bay in Torrance, CA, explains that ketamine has a half-life of approximately 4 hours. With this in mind, “Matthew Perry's death is unlikely to be related to his monitored ketamine infusion approximately one week prior,” Dr. Sivakumar says. 

He adds that “overdoses and ketamine-related deaths are typically seen in the recreation[al] setting.” In recreational settings, ketamine can be taken in powder or liquid form and can be mixed with other drugs that may also increase its risk profile, Dr. Sivakumar says.

How can ketamine use lead to death?

Ketamine-related fatalities are rare but more common in recreational versus medical settings, Dr. Sivakumar says.

When deaths occur, “high doses of ketamine can result in neurologic, gastrointestinal and potentially cardiovascular or respiratory toxicity,” he adds.

Uncontrolled doses of ketamine can also cause “transient increases” in blood pressure and heart rate, increasing risks for cardiovascular events like heart attacks, he adds.

“Additionally, high doses of ketamine can cause the brain to go into a dissociative state, preventing a person from responding to dangerous situations, such as drowning, which is what is believed to [have] happen[ed] to Matthew Perry, per the autopsy note,” Dr. Sood says.

“The real threat can come from online dispensaries that can send ketamine to various parts of the country,” Dr. Sood says. “Ketamine is a Schedule 3 controlled substance, and to have it in possession outside of a medical office can have legal ramifications.”

Guiding medical ketamine use

Perry’s autopsy sheds light on the importance of monitoring all drugs and therapies, even those that have positive medical uses.

“While ketamine has therapeutic potential, like any powerful medication, it must be administered with professional guidance [and] proper peer support to ensure safety,” says Sam Zand, psychiatrist, founder of The Anywhere Clinic, and Chief Medical Officer of Better U. “We must learn from tragedies like this and maintain reverence for the medicine to use it with proper therapeutic intention.”

Zand adds that it is important for doctors to monitor patients to whom they are administering monitored ketamine therapy and provide comprehensive education on risks and benefits to discourage improper use.