“It’s difficult to get a man to understand something when his salary depends on not understanding it.” – Upton Sinclair
Matthew Perry’s struggle with addiction is no secret.
However, it is worth considering that the medication he took is likely in line with how the medication was being prescribed. In the wake of Matthew Perry’s unfortunate passing, reportedly associated with at-home ketamine use for mental health concerns, it’s crucial to address the growing trend of individuals being prescribed ketamine for at-home self administration. While Perry had been receiving ketamine therapy in a controlled and supervised environment, a safe option for those grappling with challenging mental health conditions, the shift to at-home use—prescribed or otherwise—marked a perilous turn. As an advocate for patient well-being and responsible medical practices, I’ve always strongly advised against attempting to use ketamine without proper medical supervision.
Matthew Perry did not die of a ketamine overdose.
It’s essential to clarify that Matthew Perry did not succumb to a ketamine overdose, as intimated by some media reports. Instead, he tragically drowned after taking a substantial at-home ketamine dose (1600 mg) and sitting in his hot tub. This incident underscores the dangers of ketamine use, particularly in unsupervised settings. Confirmation bias, such as assuming that since nothing bad happened last time, nothing bad can happen this time, likely played a role in this tragic event. Several companies and providers in Chattanooga and around the country are currently prescribing sublingual doses anywhere from 150mg to 1600 mg for a single administration which to compensate for poor absorption which amplify the risks. Sublingual absorption of medications is notably poor (around 10-30%). With ketamine, the effects of a 1200 mg sublingual dose is equivalent to the effects of a much lower IV ketamine dose (150-200 mg), which, while still high, is not typically lethal. Matthew Perry’s untimely death was avoidable and unnecessary, emphasizing the critical need for medical supervision with all ketamine administration.
Matthew Perry’s case highlights a significant concern – certain companies insist that using ketamine at home is no less safe than supervised administration in a clinic. However, closer scrutiny reveals that such assertions lack any scientific support. Despite these companies boasting the ease and cost-effectiveness of at-home ketamine use, it is imperative to consider the increased risks and the lack of efficacy with sublingual administration of ketamine. It is not only significantly more dangerous but it also has the lowest chance of success when compared to any other administration modality.
The escalating instances of injuries and fatalities linked to DIY ketamine use underscore serious ethical concerns. It is disconcerting to witness some providers downplaying these risks, leaving patients insufficiently informed. Convenience should not take precedence over patient safety and treatment effectiveness. Providers utilizing this modality do so either out of greed or ignorance. While the sublingual ketamine model does offer a financial incentive and is far less labor intensive for the provider, we find that most of those prescribing at-home ketamine are well meaning. They simply are ignorant of the many risks associated with rapid acting anesthetics like ketamine. Also, the legality of at-home ketamine use gives a false sense of security, but technical legality does not equate safety or appropriateness.
In conclusion, Matthew Perry’s tragic story serves as a poignant reminder of the severe consequences associated with DIY ketamine use. It is imperative for the scientific and medical community to vehemently discourage any form of at-home ketamine use and advocate for responsible, medically supervised administration. Our commitment to those seeking help must prioritize treatments that are not only effective but, above all, safe.
