The death of “Friends” actor Matthew Perry has provided the Drug Enforcement Administration (DEA) with a mouthwatering opportunity to ramp up the drug war. A top DEA agent just publicly stated that the proliferating use of ketamine is reminiscent of the early days of the opioid epidemic that has since led to 10,000 deaths a year for almost two decades.
It’s a reaction to a fairly sudden upshot in ketamine use, a drug not historically swept up in the drug war. Its prominence is increasingly reflected in popular culture and can also be seen on billboards advertising ketamine clinics, of which there are 500 across the US. Johnson & Johnson also marketed a ketamine-based drug called Spravato in recent years, which is slated to become the first billion-dollar psychedelic drug. All of this appears to be leaving the DEA obsessed with distinguishing between legitimate and illegal ketamine use.
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“Every single day, we are targeting and investigating doctors, nurse practitioners, others, who are violating this duty of trust to their patients by overprescribing medicine or prescribing medicine that isn’t necessary,” DEA administrator Anne Milgram told CBS. “What we’ve alleged here is that these doctors were seeking a huge payout from Matthew Perry. They charged him around $50,000 over the course of one month to supply ketamine.”
During the interview, the presenter referred to Perry’s death as a “ketamine overdose,” which is lazy language for a few reasons DoubleBlind discusses in this feature about Matthew Perry’s death and how much people still don’t understand about ketamine. (Generally, ketamine only becomes toxic when mixed with large amounts of alcohol or other drugs, according to experts).
However, we would be remiss not to acknowledge the high-dose ketamine death associated with the fatality of Elijah McClain at the hands of Colorado police and paramedics in 2019. McClain, who was walking home from a convenience store, was unjustly detained and brutally held in a chokehold by Aurora cops. First responders then forcefully administered a 500-milligram dose of intramuscular ketamine to him. Anesthesiologists contend this dose was far too large for someone like McClain, who weighed only 140 pounds, and is believed to have led to his death. While drastically different scenarios, parallels can be drawn in the unique circumstances surrounding both Perry’s and McClain’s death involving intramuscular ketamine.
But the DEA’s recent remarks hark back to a not-so-bygone era in which drug misinformation was a political campaign strategy characterized by demonizing people who use (and sell) substances.
“With the opioid epidemic, there were enormous pharmaceutical companies hiring salespeople to ‘lobby’ doctors to prescribe opioids, fraudulently claiming that these new opioids were not addictive,” said Ben Spielberg, the CEO of Bespoke Treatment, which offers ketamine infusions. He acknowledged, however, that ketamine clinics often fail to appropriately screen potential new clients. “I personally have called 8 different ketamine clinics under a different name, and not a single one asked about my substance abuse history. Don’t you think that would be among the most important questions asked?” Spielberg added that ketamine should not be used as a long-term treatment, but as a short-term therapy that helps accelerate someone’s road to recovery.
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In the CBS interview, the presenter described clinics that over-prescribe ketamine as “pill mills,” further summoning the language of the opioid crisis. “We’re focused on doctors, nurse practitioners, anyone who is essentially diverting legitimate controlled substances from the normal medical practice to do what we saw happening here,” said Milgram. “These doctors were not evaluating Matthew Perry, they were not supervising injections, they were leaving behind vials of ketamine for Matthew Perry to be injected by his assistant.”
It’s rough justice for Perry’s live-in assistant, Kenneth Iwamasa, who appears to have been only following the orders of his monied boss, a person who would have procured his drug of choice one way or another. Photographs of Jasveen Sangha, the so-called “Ketamine Queen” of North Hollywood, who has been accused of being one of Perry’s dealers, have also been distributed around the world. More than 80 vials of ketamine and thousands of pills, including methamphetamine and Xanax, were found in her home, plus an unspecified amount of cocaine.
Perry became “addicted to ketamine,” according to the DEA, after undergoing infusions at a clinic seeking treatment for depression and anxiety. Ketamine is not considered physically addictive, like opioids or alcohol, and there are no felt withdrawal symptoms, but some people may develop psychological dependence and experience cravings.
Sandhya Prashad, MD, president of the Association of Ketamine Physicians, Psychotherapists, and Practitioners, told the Ecstatic Integration newsletter: “Further regulation and guardrails are certainly required. However, it is important to understand that ketamine is the only anti-suicidal / immediately lifesaving treatment within psychiatry currently that is also backed by well-conducted, rigorous trials from major academic institutions, and is a major advancement in a field where other treatments have a very low rate of response.”
