Ketamine, Exploitation and Celebrity Status

Many of us were shocked at the death of actor Matthew Perry. This was especially true if you belong to that generation who watched the sitcom ‘Friends’ religiously on NBC. Perry played the character Chandler Bing on the much beloved series, which aired from 1994 to 2024. According to the medical examiner, Perry, who had been undergoing “ketamine infusion therapy” for depression, had levels of the drug in his body in the range used for general anesthesia during surgery. Perry was was found dead, face down, in his Jacuzzi on October. 28, 2023. An autopsy revealed that the 54-year-old's cause of his death was determined to be "acute effects of ketamine," In August of 2024 California prosecutors announced that five people had been charged in connection with Perry's death. The defendants are Jasveen Sangha, 41; Dr. Salvador Plasencia, 42; Dr. Mark Chavez, 54; Eric Fleming, 54; and Kenneth Iwamasa, 59. At the time of his death, Perry was receiving ketamine infusion therapy for depression and anxiety. The medication has hallucinogenic effects that alter the perception of sight and sound and cause users to feel devoid from pain and out of control of their surroundings. As a Food and Drug Administration (FDA)-approved anesthetic, ketamine has been recognized as a fast-acting antidepressant drug for decades. Federal authorities alleged that the people charged after Perry's death exploited his addiction for their own financial gain despite knowing their actions were negatively impacting his well-being. It was well known that Perry was struggling with addiction as in the past he spoke candidly about his battles with addiction. In his 2022 memoir “Friends, Lovers and the Big Terrible Thing,” Perry opened up about his addiction and how it affected his performance on “Friends.” What is Ketamine?. Ketamine is an NMDA receptor antagonist, meaning it blocks the N-methyl-D-aspartate neurotransmitter in the brain. It was developed in the 1960s and used as a battlefield anesthetic in the Vietnam War, as well as clinically in health care settings. Ketamine is a dissociative anesthetic that has some hallucinogenic effects. It distorts perceptions of sight and sound and makes the user feel disconnected and not in control. It is an injectable, short-acting anesthetic for use in humans and animals. It is referred to as a “dissociative anesthetic” because it makes patients feel detached from their pain and environment. Ketamine can induce a state of sedation (feeling calm and relaxed), immobility, relief from pain, and amnesia (no memory of events while under the influence of the drug). It is abused for its ability to produce dissociative sensations and hallucinations. Ketamine has also been used to facilitate sexual assault. How is Ketamine used for depression?. Dr. Brandon Hamm, a psychiatrist who runs the ketamine infusion clinic at Northwestern Medicine in Chicago, said that the drug’s value lies, in part, in how fast it works. “It’s an important drug because it offers something quick and effective for something that’s a major source of disability for folks,” Hamm said. “Treatment-resistant depression causes great suffering.” A slightly different version of ketamine, called esketamine or Spravato, was approved by the FDA in 2019 for treatment-resistant depression. Esketamine is given as a nasal spray and must be administered in a doctor’s office; it’s approved only for people for whom other depression treatments have failed. Ketamine Infusion Theraphy. Ketamine infusion therapy works by giving the drug intravenously in smaller doses than those used for anaesthesia. "For depression, you use a lower dose than you use for chronic pain, a really lower dose than patients receive as anaesthetics," says Dr Mario Juruena, a psychiatrist at King's College London who specializes in treatment-resistant mental disorders. Ketamine acts faster than traditional anti-depressants - but its effects also wear off quicker. Risks Associated with Ketamine. “There are risks with ketamine, and so that’s the balance,” Hamm said. “It has a lot of power to it, and so the trouble is that there are some risks with it, and so judicious prescribing is important.” Risks include increased blood pressure, slowed breathing, bladder problems and abuse. It can also stop a person’s breathing if too much is taken or it’s taken in combination with other medications or alcohol. “If given intravenously, the drug can reach alarming, almost anesthetic dose ranges very fast,” said Dr. Padma Gulur, professor of anesthesiology and population health at Duke Health in North Carolina. “So we shouldn’t forget that this is something that should be done in a very controlled setting, because someone needs to be there to support your breathing and your vital signs. Two-edged Sword. Over the years numerous celebrities have died as a result of accidental drug overdose. Being a celebrity can be viewed as a two-edged sword. On one hand you can lend your star power and influence various causes and do good. While on the other hand those around you will exploit you while you are at your most vulnerable. People are people; some are selfish and will only stay with you for what they think they can obtain in this transactional relationship. Pain and suffering are not only for a certain class of individuals. Even with wealth, global fame and awards mental health needs urgent attention. Undoubtedly, the death of Matthew Perry was rather tragic especially for one who gave us so many light-hearted moments. Are there any positives here? Yes, the justice system works. Perry’s death unquestionably will serve to highlight the complexities surrounding the management of mental health issues. Additionally, the defendants will have to give an account of their actions. In the words of Anne Fletcher, nobody stays recovered unless the life they have created is more rewarding and satisfying than the one they left behind. Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues. waykam@yahoo.com @WayneCamo © #Ketamine #MatthewPerry