MATTHEW Perry died from acute effects of ketamine, the actor's autopsy report has revealed.
The report was made public on Friday, nearly two months after the beloved Friends star was found unresponsive in his hot tub.
Matthew's full autopsy report detailed how his assistant found him floating face down in the water when she returned to his Los Angeles home after running errands.
The assistant plunged into the hot tub and dragged Matthew's body to the steps then called 911.
First responders pulled Matthew from the water and onto the nearby grass, where he was pronounced dead.
His death was ruled an accident.
Contributing factors included "drowning, coronary artery disease, and the effects of buprenorphine," - an "opioid-like drug used in the treatment of opioid addiction as well as acute and chronic pain," the Los Angeles County Medical Examiner wrote.
Ketamine is used to treat depression and can also be taken as a recreational drug.
Matthew had undergone ketamine infusion therapy for depression and anxiety a week-and-a-half before his death, according to the report.
However, the ketamine in his system at the time of his death "could not be from that infusion therapy since ketamine's half-life is 3 to 4 hours, or less," it was reported.
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There was no evidence of alcohol or other drugs like cocaine, methamphetamine, heroin, PCP, or fentanyl in the actor's system.
The report was finally released on Friday after experts warned it could take weeks before it was complete.
'HIGH LEVELS OF KETAMINE'
Senior deputy medical examiner Raffi Djabourian found that there were "high levels of ketamine found in his post-mortem blood specimens."
"The main lethal effects would be from both cardiovascular overstimulation and respiratory depression," the report stated.
"Drowning contributes due to the likelihood of submersion into the pool as he lapsed into unconsciousness; coronary artery disease contributes due to exacerbation of ketamine-induced myocardial effects on the hearts."
While the medical examiner ruled that "the ketamine in his system at death could not be from that infusion therapy," they were not able to specify the "exact method of intake" in Matthew's case.
The report suggests Matthew had been "reportedly clean for 19 months" from drug use, though other close peers have claimed otherwise.
TRAGIC END
Matthew died on October 28 at his Los Angeles home at the age of 54 to the shock of fans around the world.
The comedian's friends have insisted that he was clean and sober in his final years of his life and he was known for being active at his home in the Palisades.
He was vocal about his past struggles with addiction and had detailed some of his health problems in his 2022 memoir Friends, Lovers and the Big Terrible Thing.
Matthew had a brief stint on life support in 2018 and was in a coma for two weeks after several medical episodes.
He endured more than a half-dozen stomach surgeries and used a colostomy bag for nine months in addition to suffering from pneumonia and an exploded colon.
The star's longtime barber, Pierre Johnson Jr, exclusively told The U.S. Sun that Matthew had even tried to cut back on smoking which was his "last bad habit."
"He had a home gym inside of his place in the Palisades, and I knew he’d taken up pickleball again," Pierre said.
"It was his last bad habit, he was so keen to quit, it’s why he took up pickleball.
“It was enjoyable, you didn't need to be some gym-crazy person in order to have fun doing it. And it's cardio."
He went on: “His fingers were brown from smoking. He even went to see a hypnotist to try and quit. Often we smoke because we’re stressed."
Pierre said he never saw Matthew drink an alcoholic beverage and believed he was clean and sober in his final years after opening up fully about his struggles in his memoir.
"His story was changing lives, and I was so glad to see that he was on the other side of [his addiction]," he said.
'RED FLAGS' BEFORE HIS DEATH
Despite many believing Matthew was sober, his ex-girlfriend and former assistant Kayti Edwards told The U.S. Sun that she feared he suffered a drug relapse before he died.
She said: “There are a lot of things that aren’t adding up for me.
“I don’t believe he just drowned in his Jacuzzi, that doesn’t sound right.
“I know Matthew and I know that he wouldn’t have just drowned.
“I think he might have taken pills in the week leading up to this.
“They said there were no prescription painkillers at the scene, which doesn’t surprise me, because he didn’t leave drugs lying around.
“He was paranoid and would take them all, so there wasn’t any evidence, and then go out for more when he was ready to.”
A friend who met with Matthew the day before he died said that he seemed “100 percent sober” and “extremely positive.”
But mother-of-four Kayti said she spotted red flags that all was not well with Matthew in the days before his death.
The actor, who shot to fame playing Chandler Bing, had been posting much more than usual on social media, which she says was out of character.
His final post, from five days before his death, showed him in the Jacuzzi and was signed “Mattman,” his alter ego based on his obsession with comic book character Batman.
Kayti said: “That Mattman thing was not something he did when he was sober.
“Mattman would come out when he was not sober and he felt kind of invincible.
“I was around when he was getting high, although I was not getting high with him, and when I would say maybe he should cool it a little bit with the drugs, he would say, ‘No, I’m Mattman’.”
FRIENDS FOR LIFE
After a period of silence following his heartbreaking death, Matthew's Friends co-stars finally released statements on social media in November.
Jennifer Aniston, Courteney Cox, Matt LeBlanc, Lisa Kudrow and David Schwimmer each spoke from the heart.
Lisa was the final star to share a post and next to a of the two co-stars, she wrote: "Shot the pilot, Friends Like Us, got picked up then immediately, we were at the NBC Upfronts.
"Then…You suggested we play poker AND made it so much fun while we initially bonded. Thank you for that.
"Thank you for making me laugh so hard at something you said, that my muscles ached, and tears poured down my face EVERY DAY.
"Thank you for your open heart in a six-way relationship that required compromise. And a lot of 'talking.'
"Thank you for showing up at work when you weren’t well and then, being completely brilliant.
"Thank you for the best 10 years a person gets to have.
"Thank you for trusting me.
"Thank you for all I learned about GRACE and LOVE through knowing you.
"Thank you for the time I got to have with you, Matthew."
Jennifer, 54, shared a screenshot of text messages between the two and wrote in a caption: "Matty, I love you so much and I know you are now completely at peace and out of any pain. I talk to you every day… sometimes I can almost hear you saying 'could you BE any crazier?'"
Courtney, 59, shared a blooper clip from the show and captioned the video: "In this scene, before we started rolling, he whispered a funny line for me to say. He often did things like that. He was funny and he was kind."
Matt, 56, posted a series of photos of them together on set and wrote: "It was an honor to share the stage with you and to call you my friend. I will always smile when I think of you and I’ll never forget you. Never. Spread your wings and fly brother you’re finally free. Much love. And I guess you’re keeping the 20 bucks you owe me."
David, 57, posted a throwback photo of him and Matthew on the set of Friends and wrote: "I imagine you up there, somewhere, in the same white suit, hands in your pockets, looking around— 'Could there BE any more clouds?'"
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The cast mates reunited at a ceremony for Matthew on November 3.
They were pictured looking somber as services were held at Forest Lawn Memorial Park, the burial site of some of Hollywood's biggest stars.