Is Psychedelic Medicine Safe for Ex-Addicts? A Ketamine Therapist on Matthew Perry’s Tragic Death

You’ve likely heard the tragic news that Matthew Perry, the beloved actor best known for his role in Friends, died from an overdose in the fall of 2023. Perry famously struggled with addiction for years but had reported being in recovery at the time of his death. What has caught national attention, however, is the substance involved in his death: ketamine. Originally developed as an anesthetic, ketamine has more recently gained widespread use as an antidepressant in mental health treatment across the country. Perry’s overdose has raised serious concerns about the safety of this drug, especially in the context of addiction recovery. As a therapist who practices ketamine-assisted psychotherapy (KAP), I want to provide some clarity about this substance and whether it’s safe for those struggling with addiction.

What is Ketamine?

Ketamine was initially developed in 1962 as an anesthetic for use during surgery, and it was FDA-approved in 1970 for this purpose. Over time, however, ketamine became widely known as a popular party drug under the street name "Special K." It wasn’t until more recently that researchers discovered ketamine’s powerful effects on mental health—specifically, its ability to alleviate symptoms of depression and promote neural plasticity. Neural plasticity refers to the brain’s ability to adapt and reorganize itself, which is crucial in the treatment of various mental health disorders.

The emergence of ketamine as a treatment for depression and other mental health conditions has caused a boom in the use of the drug in clinical settings. For individuals suffering from treatment-resistant depression (i.e., depression that hasn’t responded to traditional antidepressants or talk therapy), ketamine has been nothing short of a breakthrough. In many cases, patients experience immediate improvements in mood and a reduction in depressive symptoms, sometimes after just one treatment.

Ketamine is Safe—When Used as Prescribed

The bottom line is that ketamine is generally safe when taken as prescribed. The reality is that no medication is safe if misused or abused. The safety of most drugs is determined by the dosage and how the drug is administered. For example, you can technically overdose on water if you drink too much of it. In the case of Matthew Perry, it wasn’t the therapeutic dose of ketamine that led to his death; it was the excessive amount he consumed. According to reports, Perry was administered 27 shots of ketamine in a short period of time prior to his passing.

When used in controlled, clinical settings, ketamine is actually quite safe for most patients. It has very few contraindications compared to many other medications. However, like any treatment, there are certain risks. People with certain health conditions—such as cardiovascular disease, high blood pressure, or psychosis—should be carefully monitored when undergoing ketamine therapy. While ketamine is a safe and effective treatment for many, it is important to consider individual health factors and the proper context in which it’s used.

When to Be Cautious

Ketamine should be prescribed with extra caution to individuals with a history of substance use disorders. Although ketamine is not prescribed for recreational use, it is a drug that induces a high, and that can be problematic for someone with a history of addiction. It’s undeniable that someone with a history of substance abuse may be triggered by the drug, even if they are receiving treatment under the supervision of a doctor.

For most patients undergoing ketamine therapy, the experience can be intense. Many people report feeling profoundly disoriented or even detached from reality during their treatments. This is not unusual, as ketamine works by altering brain chemistry and perception. In fact, the experience can be so intense that patients are often supervised during treatments, especially when receiving ketamine infusions or intramuscular injections. The dosages used in clinical settings can be much higher than those typically used recreationally, so even individuals with prior ketamine use may find the experience overwhelming.

For individuals in recovery from addiction, the effects of ketamine can be a double-edged sword. While it may have therapeutic benefits, it also has the potential to reignite old patterns of behavior. The very nature of ketamine’s effects could make someone more susceptible to relapse, particularly if they’ve been in recovery for a short period of time. That’s why it’s crucial that those with a history of addiction are thoroughly assessed before undergoing ketamine therapy, and that they are closely monitored throughout the process.

Can Ketamine Therapy Treat Addiction?

What’s particularly interesting about ketamine is that it’s not just a treatment for depression. There is growing evidence that ketamine can be an effective tool in treating substance use disorders. Recent studies have shown that ketamine can significantly reduce alcohol consumption, with one study showing a reduction of up to 66% in alcohol intake among chronic alcoholics. This is in stark contrast to the 22% reduction observed in the placebo group. Other studies have also suggested that ketamine may be effective in treating opioid addiction and other substance use disorders.

One of the reasons ketamine may be effective in treating addiction is that it can disrupt ingrained neural pathways associated with cravings and compulsive behaviors. Ketamine has been shown to promote neuroplasticity, which means it can help “reset” the brain in a way that allows individuals to break free from old, addictive patterns. Some proponents of ketamine therapy have even suggested using it in inpatient drug and alcohol treatment centers as a potential adjunct to traditional therapies.

However, not everyone in the medical community is convinced that ketamine is a reliable treatment for addiction. While some patients may experience a reduction in cravings, others may feel triggered by the drug, potentially leading to a relapse. The effects of ketamine on addiction are still being studied, and more research is needed to determine its long-term effectiveness for treating substance use disorders.

The Wild West of Ketamine Clinics

The current state of the ketamine market is somewhat chaotic. In recent years, the availability of ketamine therapy has exploded, with more and more clinics popping up offering treatment for everything from depression to chronic pain. Unfortunately, many of these clinics are not operating under strict medical supervision or following evidence-based protocols. In some cases, patients may be prescribed ketamine without receiving proper therapeutic support.

One of the biggest concerns with the rapid growth of the ketamine industry is the lack of standardization in treatment protocols. Most ketamine clinics focus solely on the administration of the drug and do not incorporate psychotherapy or other therapeutic interventions. This can be problematic because ketamine therapy is often a deeply transformative experience, and patients need guidance to process their emotions and integrate their experiences afterward. Without the proper support, some individuals may find the experience overwhelming or even traumatizing.

Additionally, some clinics over-prescribe ketamine, encouraging patients to schedule more treatments than are necessary or advisable. These practices can lead to a cycle of overuse, which can increase the risk of side effects or dependency. As with any treatment, it’s important to find a reputable provider who follows best practices and takes a holistic approach to treatment.

A Ketamine Therapist on Matthew Perry

I believe that we should approach the use of ketamine with the same caution and respect that we would any other treatment. As a ketamine-assisted therapist, my hope is that Matthew Perry’s tragic death will not deter individuals who could benefit from ketamine therapy from seeking help. However, his death should serve as a reminder of the importance of proper oversight and monitoring when using this powerful substance.

In the mental health field, we’re constantly learning and evolving. It’s essential to remain humble and teachable. While ketamine therapy can be highly effective, it is not a one-size-fits-all solution. We must respect medical and therapeutic protocols to ensure that patients receive the safest and most effective care possible. Perry’s case should serve as a learning experience for both patients and practitioners alike.

If you want to learn more about my practice or ketamine assisted psychotherapy, you can book a complementary consultation with me here.