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Acute Effects of Ketamine – What Does That Mean and Why Did Matthew Perry, Star of Friends, Die from It?

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Matthew Perry, renowned for his role in “Friends” and publicly addressing his prolonged struggles with substance abuse, passed away at the age of 54. The Los Angeles County medical examiner’s office, in an autopsy report released on Friday, identified the primary cause of Perry’s death as the “acute effects” of ketamine, a potent anesthetic with psychedelic properties.

 

Perry was discovered unresponsive in a hot tub at his Los Angeles residence on October 28. The autopsy report listed additional factors contributing to his demise, including drowning, coronary artery disease, and the presence of the opioid buprenorphine in his system.

 

Despite undergoing ketamine infusion therapy, the autopsy ruled out the possibility that the ketamine detected in Perry’s system originated from his last known therapy session, which occurred about a week and a half before his death.

 

The report emphasized that the elevated levels of ketamine found in Perry’s postmortem blood could result in cardiovascular overstimulation and respiratory depression. The concentration of ketamine was noted to be equivalent to that used in general anesthesia. Despite ketamine’s growing use as an alternative therapy for mental health conditions, it is also known to be used recreationally.

 

In October, the Food and Drug Administration issued a warning alerting the public to the hazards of using compounded versions of drugs for treating psychiatric disorders. Additionally, toxicology tests revealed the presence of “therapeutic” levels of buprenorphine, a drug commonly prescribed for drug addiction and pain management. Perry’s live-in assistant stated in a witness statement that Perry was under the care of a psychiatrist and took buprenorphine as prescribed twice a day. Although investigators found evidence of sedatives, there was no indication of alcohol, methamphetamine, or cocaine in his system.

 

Details surrounding the day of Perry’s death were disclosed in unsealed records from the autopsy report. Witnesses informed detectives that Perry had engaged in pickleball at 11 a.m. His assistant left the residence for errands around 1:37 p.m. and returned at 4 p.m. to discover Perry “floating face down.” The assistant promptly called 911 moved Perry onto the steps, and initiated CPR. Despite paramedics’ efforts, Perry was pronounced dead after being pulled from the water.

 

Dr. Judy Melinek, an independent forensic pathologist, commented in October that delays in test results were expected due to a shortage of qualified toxicologists, funding constraints, and equipment availability. Emphasizing the necessity of a thorough investigation, Melinek noted that such processes could take months.

 

Matthew Perry, openly discussing his struggles with substance abuse, faced hospitalizations for various health issues over the years. In his 2022 memoir, “Friends, Lovers and the Big Terrible Thing,” Perry detailed health challenges, including a series of medical episodes in 2018 that involved pneumonia, an exploded colon, a period on life support, two weeks in a coma, nine months with a colostomy bag, and multiple stomach surgeries.

 

Perry catapulted to fame at the age of 24 with the iconic role in “Friends,” experienced a successful run during the show’s 10 seasons from 1994 to 2004. Following the sitcom, Perry appeared in several films, though not all achieved box-office success. Tributes poured in from fans and colleagues after his death, with fellow “Friends” actors expressing devastation and highlighting their bond as a family beyond being cast mates.

 

What is Ketamine?

 

Ketamine is categorized as a dissociative anesthetic hallucinogen, inducing a sense of detachment from pain and surroundings while distorting perceptions of sights and sounds.

 

Approved as a short-acting anesthetic for both humans and animals, ketamine is also employed off-label to manage post-surgical and acute pain. Dr. Amber Borucki, an associate professor of anesthesiology, perioperative, and pain medicine at Stanford University, and a member of the Pain Committee for the California Society of Anesthesiologists, notes its use in hospitals typically involves low-dose IV infusions.

 

A specific variant of ketamine known as esketamine, or S-ketamine, is sanctioned as a nasal spray for treating treatment-resistant depression in adults.

 

Is Recreational Ketamine Hazardous?

 

According to Sivakumar, instances of overdoses and fatalities associated with ketamine are predominantly linked to recreational use rather than clinical applications.

 

Recreational ketamine, often ingested as a powder or liquid, may be combined with substances such as MDMA (ecstasy), amphetamine, methamphetamine, and cocaine. While the side effects observed in clinical settings may also manifest in recreational use, higher doses can exacerbate their severity.

 

Sivakumar warns that elevated ketamine doses can lead to neurological, gastrointestinal, and potentially cardiovascular or respiratory toxicity. Symptoms of a ketamine overdose encompass loss of consciousness, dangerously slow breathing, and heart-related issues like a slow heart rate or even a heart attack.

 

Prolonged recreational ketamine use may result in enduring psychiatric effects, including depression, impaired memory, and concentration. Further complications of extended use may involve bladder problems, abdominal and pelvic pain, blood in the urine, and potential liver issues.

 

Seeking Assistance for Substance Addiction

 

In addition to various adverse effects, ketamine “poses a risk for [misuse], and the potential to cause severe psychological and/or physical dependence,” as emphasized by Borucki.

 

Recognizing when your usage of this substance might be evolving into a substance use disorder involves being attentive to certain indicators:

 

1. Inability to Curtail Use: Persistent difficulty in slowing down or discontinuing use, even after making repeated attempts to quit.

 

2. Compulsive Urges: Experiencing compelling and uncontrollable urges to use the drug.

 

3. Neglecting Relationships: Failing to prioritize family, work, or other relationships due to drug use.

 

4. Persistent Use Despite Harm: Continuing to use the drug despite being aware of its detrimental impact on your health and overall life.

 

5. Increased Tolerance: Requiring higher doses of the drug to achieve the same desired effect.

 

6. Withdrawal Symptoms: Encountering painful physical or psychological withdrawal symptoms when attempting to cease usage.

 

Recognizing these signs is crucial in taking the first steps toward seeking assistance and addressing potential substance addiction issues.

 

Bottom Line

 

Matthew Perry’s tragic passing highlights the profound challenges of addiction, specifically the alarming impact of ketamine misuse. As we reflect on Perry’s public struggles and the autopsy’s revelations, it becomes evident that substance misuse is a complex issue with potentially severe consequences. The article not only commemorates Perry’s legacy but also underscores the critical need for awareness about the risks associated with recreational ketamine use and the importance of recognizing signs of substance use disorder. Perry’s story serves as a poignant reminder of the ongoing battle against addiction, urging society to prioritize mental health conversations and seek help for those in need.

 

KETAMINE FOR DEPRESSION, WHAT WE KNOW SO FAR…

KETAMINE FOR DEPRESSION

KETAMINE FOR DEPRESSION, IS IT WORKING AND WHAT IS NEW?



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How Legal is CBD, Really?

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The legality of CBD remains a subject of considerable debate. Despite the fact that many CBD companies[1]  have now existed for more than a decade, the legal context surrounding this non-intoxicating cannabinoid remains muddy for the average shopper. In this guide, we’ll explore the legality of CBD in detail, examining the implications along the way.

History of CBD Laws

Extracts of Cannabis sativa have been widely prepared and sold for centuries beyond count. It’s unclear exactly when human beings and cannabis intersected, but it’s believed cannabis has been a part of daily life at least as long as apples and potatoes.

 

It’s only recently that laws have turned discriminatory toward cannabis. Starting in Europe in the 19th century, this anti-cannabis fervor eventually reached the United States, spurring the “Reefer Madness” craze that ultimately led to cannabis being illegalized with the 1937 Marihuana Tax Act.

 

In 1970, the Controlled Substances Act sealed the deal, and hemp was not grown in considerable acreage until academic pilot programs began resurfacing in the early 2000s. By the early 2010s, legal loopholes were identified at the federal level that allowed CBD commerce to emerge online.

 

In 2014 and 2018, the United States Congress gave CBD the nod with Farm Bills that facilitated hemp cultivation and commerce. Not much has changed in the ensuing years, however, leading to a hemp economy that has begun to stagnate in some sectors.

Recent Developments in CBD Legislation

Cannabis-related measures continue to be proposed at both the state and federal level. Few of them focus specifically on CBD, however, which remains in a gray area loosely delineated by the 2018 Farm Bill and subsequent clarifications from the FDA, DEA, and USDA.

 

It appears the situation with CBD will remain unclear federally for the foreseeable future. There seems to be an “unwritten rule” that upstanding CBD companies will not run afoul of federal agencies as long as their conduct meets a certain unofficial threshold.

 

The FDA continues to issue warning letters to CBD companies that violate the dictates of the 2018 Farm Bill, but enforcement is rare and usually amounts to relatively small fines. At the state level, legislators continue to evolve their stances on CBD and related products, mainly in an effort to siphon tax revenue.

Potential Future CBD Regulations

Over time, the slew of largely unrelated hemp and cannabis laws continuously being produced by Congress may begin to amount to a comprehensive federal stance on cannabinoids. At this current juncture, however, cannabinoid regulations ever more commonly have less to do with the shopper’s interests and more to do with securing government revenue.

 

The ideal solution that hemp proponents have expounded for years, namely that CBD be judged an over-the-counter substance, appears further and further away as time goes by. At present, it seems the de facto approach is to not address the underlying legality of cannabinoids but to instead determine how best they should be taxed.

 

It might not be an ideal situation, but for the average CBD producer, this is still good news. There was a time in the not-so-distant past when it seemed the federal government was on the verge of attempting to ban CBD products outright. Though the current circumstances may remain muddy, at least there’s no longer any indication that the federal government is antithetical to hemp and CBD overall.

CBD Legality: The Bottom Line

As we finish up, it’s important to carefully address a few final points:

CBD regulations vary by state

For most intents and purposes, CBD can be considered federally legal. Each state has its own laws and regulations pertaining to CBD and other cannabinoids, however, some of which are more restrictive than others. CBD laws can be restrictive both in states that are firmly anti-cannabis and in those that have newer adult-use cannabis industries that suffer from direct competition with online CBD vendors.

No medical claims

CBD is certainly not legal when it is advertised as offering medical benefits. It’s fine to reference evidence that CBD might be useful for a particular ailment. To outright say that CBD treats or cures a medical condition, is tantamount to asking for the scrutiny of the federal government.

Professionalism first

The CBD companies that are currently succeeding are those that go above and beyond. Clean products, transparent communication, impeccable certification: these are the hallmarks of the future’s top CBD brands. Focusing on quality will make it less likely to flub regulations.

Respect CBD

CBD is a powerful compound, and it comes from a plant that has an amazing power to heal. Put CBD’s benefits first and foremost, and you’ll find that your company naturally begins to fit the parameters that both shoppers and regulators approve of most.



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California Cities: Prohibition Doesn’t Work

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California has a population of nearly 40 million, six years of cannabis licensing, but only has about 1,200 licensed dispensaries. These stores are mostly spread out in highly populated areas like Los Angeles, San Francisco, and so on. The problem is that many California cities still prohibit cannabis licensing, even in places where a majority of the locals approved the state’s recreational cannabis program in 2016. This is a massive problem and is one of the key reasons the illegal market thrives. Let’s look at why that is the case and what these cities can do to change it.

Why prohibition doesn’t work

When the government prohibits something, there is an existing market for that thing, and a fear on the part of the government (justifiable or otherwise) that failure to prohibit it would lead to some kind of societal harm. Because there is an existing market for the thing, there is necessarily some kind of demand for it. If the government bans the thing, some people will realize that the potential cost (prison, fines, stigma, etc.) outweighs the benefit, and demand will go down.

But others will find that the benefit outweighs the potential cost, no matter how high it is — which is why people still roll the dice in countries like Singapore that will execute drug traffickers. So while prohibition may decrease demand, it won’t end it. And so long as there is some demand, again, some people will roll the dice.

This is exactly what has happened in the decades since cannabis was prohibited. If prohibition were an effective deterrent, then you would expect there not to be a high level of use or incarceration. But we’ve seen the opposite. There have been millions of people arrested and incarcerated for violating the Controlled Substances Act and state-law counterparts. It’s pretty clear then that these laws don’t have their intended effects, which brings me to the next point.

What problems are California cities creating?

When California voters passed the state’s flagship recreational licensing law in 2016, California cities were given an immense amount of control over the new industry. Perhaps realizing the initiative would face strong opposition if it took power away from cities, the drafters included provisions that allowed California cities to completely ban cannabis activities within their limits. These provisions led to local bans in vast swathes of the state.

While cities have slowly “come online” over the years, there are still vast swathes of the state without legal access to cannabis. In fact, many cities even sued the state when it tried to officially sanction statewide delivery rules. What this means is that there are still many California cities that prohibit cannabis.

If those cities are trying to eliminate local cannabis markets, I’ve got a bridge to sell them. Prohibition didn’t work before the state legalized cannabis, and it certainly won’t work when the state won’t lift a finger on enforcement. California cities that keep their bans alive are only bolstering their illegal markets and making it more difficult for the legal market to survive.

What California cities should be doing to combat the illegal market

I recently corresponded with Hirsh Jain of Ananda Strategy, who believes that the state needs 4,000 to 5,000 dispensaries to carry the legal market. And those dispensaries shouldn’t just be in Los Angeles or San Diego. They’d need to be dispersed across the state so that people have access and the legal dispensaries could compete with the illegal ones (and ideally put them out of business). If more California cities don’t end prohibition, illegal dispensaries and delivery services will continue to operate whether they like it or not.

That said, there are other things that California cities can do to combat the illegal market without allowing brick-and-mortar sales. One big one would be to allow outside delivery services to deliver into their borders. While the state did pass a law attempting to expand statewide access to medical cannabis deliveries, that fails to include the much larger recreational market. It also likely excludes potential medical cannabis purchasers who don’t want to or don’t have the resources to obtain a physician’s recommendation or medical marijuana ID card (MMIC).

Expanding retail deliveries would be a win-win for the legal market and cities alike. Yet for some reason, California cities fought it tooth and nail. While those cities may have thought they won, the real victory belonged to the illegal market, which continues to grow and grow.


If the legal market is to survive, California cities are going to have to make compromises when it comes to cannabis prohibition. After all, cannabis is still being sold within their borders. For some of my thoughts on California’s problematic illegal market, check out these posts:





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The Good ‘Dirty Little Secret’ about Weed

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You may remember that Justin Timberlake once said, “Some people are just better on weed”. Well, if he was referring to people with ADHD or ADD, he may be right.  While many studies on marijuana for ADD or ADHD show great results to help people with “scatter” brain start to focus, UFC Sean O’Malley is the latest person to preach the plants’ benefits for focus.

Bantamweight champion Sean O’Malley breaks the stereotype associated with marijuana users. At 29, he incorporates marijuana into his training regimen to achieve a state of intense focus, which appears to yield positive results.

 

In an interview with Demetrious Johnson, O’Malley clarified misconceptions about his marijuana use: “Contrary to popular belief, I don’t consume as much as people assume.” Asserting his professionalism as an athlete, he claims to excel in managing his recovery compared to others in the UFC, attributing it to his disciplined habits and routines.

 

Recognizing the potential drawbacks of smoking on lung health and conditioning, O’Malley adopts measures to safeguard his fitness standards. He opts for vaporizing marijuana, particularly during training camps, using a high-quality vaporizer once daily instead of traditional methods like joints, bongs, pipes, or dabbing.

 

O’Malley reveals that during specific training sessions, such as longer, lower-intensity workouts lasting up to 60 minutes, he trains while under the influence, leveraging marijuana to enhance his focus. However, he acknowledges the importance of using it as a tool responsibly, cautioning against falling into unproductive habits like aimlessly watching YouTube while high.

 

The upcoming UFC 299 main event on March 9 sees O’Malley defending his 135-pound championship title for the first time against his rival, Marlon “Chito” Vera. Seeking redemption for his only career loss, which Vera inflicted upon him at UFC 252 in August 2020, O’Malley is determined to emerge victorious.

 

The Science Behind O’Malley’s Approach

 

Sean O’Malley’s use of cannabis to increase concentration during training begs interesting concerns concerning the relationship between marijuana use and athletics. Cannabis includes chemicals like THC and CBD that interact with the brain’s endocannabinoid system to influence a variety of physiological activities, despite being frequently linked to relaxation and altered perception.

 

Studies suggest that low to moderate doses of THC may improve focus, creativity, and cognitive performance in some individuals, potentially explaining O’Malley’s reported ability to “hyper-focus” during workouts. Additionally, CBD, another prominent compound in cannabis, has been linked to reduced anxiety and improved recovery, which could complement O’Malley’s training regimen.

 

However, the effects of cannabis on athletic performance remain complex and multifaceted. While some athletes may experience benefits in terms of concentration and relaxation, others may encounter impairments in coordination, reaction time, and cardiovascular function. Furthermore, individual responses to cannabis can vary widely based on factors such as dosage, method of consumption, and personal tolerance levels.

 

Experts caution that while cannabis may have its place as a performance-enhancing tool for certain athletes, careful consideration must be given to its potential drawbacks, including the risk of dependence, negative effects on lung health, and legal implications, particularly in professional sports settings.

 

O’Malley’s method offers as an engaging case study for negotiating the complex link between cannabis use and sports performance as researchers continue to investigate the physiological and psychological impacts of cannabis. O’Malley starts a wider discussion about the place of cannabis in contemporary sports training and competition by illuminating the science underlying his unorthodox training techniques.

 

Managing Marijuana Use in Professional Athletics

 

Navigating the use of marijuana in professional athletics involves a delicate balance between personal choice, regulatory compliance, and performance optimization. Despite evolving attitudes toward cannabis, organizations like the UFC maintain stringent anti-doping policies, prohibiting its use above specified thresholds during competition periods. Athletes such as Sean O’Malley must therefore carefully manage their marijuana consumption to ensure adherence to these guidelines while still leveraging its potential benefits for training and recovery.

 

For O’Malley and others incorporating cannabis into their routines, managing marijuana use requires strategic planning and adherence to regulatory standards. This involves selecting consumption methods and timing consumption to minimize the risk of exceeding allowable THC thresholds during testing. O’Malley’s transparency about his usage patterns and advocacy for responsible consumption practices set a precedent for athletes navigating the complex landscape of drug policy in professional sports.

 

Professional sports may see more changes in policies and attitudes as talks about decriminalizing and legalizing cannabis continue. Athletes who are willing to share their personal stories and advocate for more nuanced approaches to drug policy, such as O’Malley, are vital in influencing this conversation. Going forward, managing the changing link between cannabis usage and sports performance will need constant communication and cooperation between players, coaches, and regulating authorities.

 

O’Malley’s Training Rituals: Balancing Intensity and Recovery

 

Gain insight into Sean O’Malley’s methodical strategy to integrating cannabis into his routine while striking a balance between intensity and recuperation by learning about his training rituals. To maximize effectiveness in the octagon, O’Malley’s training regimen combines focused rest times with intense sessions in a calculated manner.

 

The understanding that efficient recuperation is equally as important as intense exercise is at the heart of O’Malley’s training philosophy. O’Malley makes sure that his body can adjust and get stronger in response to the demands of his training routine by using restorative habits like healthy eating, drinking enough of water, and getting enough sleep. When utilized responsibly, cannabis is another weapon in O’Malley’s toolbox that he can employ to improve concentrate during longer, lower-intensity sessions without jeopardizing his recuperation.

 

O’Malley is a perfect example of the value of an all-encompassing approach to sports training as he strikes a balance between effort and recuperation. O’Malley reduces the chance of injury and fatigue while simultaneously optimizing his performance capacity by placing equal emphasis on restorative techniques and physical activity. O’Malley’s training regimens are always being improved, and his techniques are proof of the need of smart, individualized approaches to physical preparation for success in the UFC and other competitions.

 

Bottom Line

 

Sean O’Malley’s pioneering approach to incorporating cannabis into his training regimen challenges stereotypes and opens up discussions about its potential benefits and drawbacks in professional athletics. His transparency and advocacy for responsible usage set a precedent for athletes navigating complex drug policies while seeking performance optimization. As attitudes toward cannabis continue to evolve, ongoing dialogue and collaboration among athletes, coaches, and governing bodies will be crucial in shaping policies that balance regulatory compliance with individual health and performance goals. O’Malley’s dedication to balancing intensity and recovery underscores the importance of personalized, holistic approaches to training, serving as a blueprint for athletes striving for success in high-level competitions like the UFC.

 

CANNABIS AND ADD/ADHD, READ ON…

CANNABIS USER HAVE ADHD

50% OF CANNABIS USERS SUFFER FROM ADD OR ADHD? WHAT?



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