Matthew Perry, star of the popular television show Friends, died last October from an overdose of ketamine, the Schedule III drug known as a “dissociative anesthetic hallucinogen.” Ketamine can lead to physical dependence, but it has an even higher potential for psychological dependence.

     Ketamine was approved in 1970 by the FDA for use as an anesthetic for certain diagnostic and surgical procedures. It was initially used as a veterinary anesthetic.

     Per reports, Perry spent $55,000 in cash to buy illegal vials of ketamine and had his personal  assistant inject him with it, apparently multiple times the day of his death. It is a sad story. The vials he purchased cost the suppliers $12.00 each, but he was paying nearly $3000 per vial.

     How did he get in such desperate shape to spend that kind of money to satisfy his addictive craving for the drug?

     He had been undergoing “legal” ketamine-assisted psychotherapy until the week before his death. In fact, he had begun having daily ketamine infusions as early as 2000.

     Today there may be as many as 750 ketamine infusion therapy clinics operating in the U.S. Each patient session typically costs between $600.00 and $1000.00. The exact infusion protocol is determined at each individual clinic, but patients usually start at a lower dose of ketamine and increase it if the lower dosage is not effective.

     It is all off-label drug use, and none of it is approved by the FDA.

     While the doctors who run the clinics are often anesthesiologists or psychiatrists, there is no standard protocol today for the administration of ketamine infusion therapy.

     By 2022 annual revenue for ketamine therapy was estimated to be $3.1 billion and projections suggest that figure could arise to $6.9 billion over the next six years.

     There’s a gold rush mentality within this burgeoning industry, and Googling “ketamine infusion therapy” brings you immediately to a host of sites ushering you toward local ketamine clinics poised and ready to start your off-label therapy immediately.

     How much of Matthew Perry’s desperate measures to feed his ketamine addiction the week of his death were the result of his increasing addiction to it, fueled by his long term ketamine therapy sessions? One can’t say. But given the black box warning for the drug, its lack of approval for this use by the FDA, the questionable protocol of its administration in today’s unregulated clinics, and at least one prominent example of its dangers in Matthew Perry’s case, and one can say that any current “legal” use of ketamine should be questioned.

     If ketamine addiction prompts the behavior we saw in Mathew Perry his final days, how many ketamine sessions at a ketamine clinic does it take to begin to move some other unsuspecting soul into the same desperate moves prompted by that addiction?