Matthew Perry died of 'acute effects of ketamine,' autopsy report shows: The latest

Matthew Perry's cause of death was due to "acute effects of ketamine," the Los Angeles medical examiner announced Friday. The autopsy report was released nearly two months after the actor was found dead in his Los Angeles home. Drowning, coronary artery disease and the effects of buprenorphine, which is used to treat opioid use disorder, were listed as contributing factors. Perry was candid about his years-long addiction to opioids. The manner of death has been ruled an accident ("drug and drowning related").

The autopsy report goes through Perry's health leading up to his death. It noted the actor's "history of chronic obstructive pulmonary disease/emphysema" and diabetes. It called out past drug use, but noted that Perry had been reportedly clean for 19 months. While he had been a heavy smoker for many years, the actor purportedly stopped smoking two weeks before his death. However, the most notable comment was that Perry underwent "ketamine infusion therapy," which was administered by a doctor, most recently one-and-a-half weeks before his death.

Ketamine therapy is an increasingly popular mental health treatment. People typically receive the drug intravenously. Ketamine, which has been used as an anesthetic since the '60s, is also taken recreationally. It first gained popularity as a club drug in the '90s due to its psychedelic effects.

"The exact method of intake in Mr. Perry's case is unknown," the autopsy report stated, which noted the actor was apparently using ketamine therapy to treat anxiety and depression. However, the coroner stated that "the ketamine in his system at death could not be from that infusion therapy." The levels of ketamine in Perry's body at the time of his death were so high, it was in the range used for general anesthesia during surgery. The drug is typically metabolized in a matter of hours, so it could not have been from the treatment more than a week prior.

"At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular overstimulation and respiratory depression," the report read. "Drowning contributes due to the likelihood of submersion into the pool as he lapsed into unconsciousness."

Perry died at his home in the Pacific Palisades neighborhood of Los Angeles in the afternoon of Oct. 28. No illicit drugs were found at the scene; prescription medications were recovered. The autopsy noted none were found by the pool. Perry was found dead in his hot tub and pronounced dead at the scene. Foul play was ruled out.

According to Perry's death certificate, the actor died at 4:17 p.m. His stepfather, Keith Morrison, is listed as the informant, which means the Dateline host is the person who identified Perry to authorities.

A spokesperson for the Los Angeles Police Department told Yahoo Entertainment at the time of Perry's death that officers responded the block of "Blue Sail Drive at 4:10 p.m. for a death investigation of a male in his 50s." The Los Angeles Fire Department, which was first on scene, added that responders arrived at the residence "to find an adult male unconscious in a stand-alone hot tub."

"A bystander had brought the man's head above the water and gotten him to the edge, then firefighters removed him from the water upon their arrival," Capt. Adam Van Gerpen noted in a statement. The bystander was reportedly Perry's assistant, per TMZ. When the assistant returned to the house, he reportedly found Perry in the hot tub.

"A rapid medical assessment, sadly, revealed the man was deceased prior to first responder arrival," the Fire Department added. The investigation was led by the Los Angeles Police Department's robbery homicide division.

An autopsy was completed on Perry on Oct. 29, but the cause of death was deferred pending the toxicology report.

Hours before Perry died, the actor had spent the morning playing pickleball at his nearby country club. The Friends star's former pickleball coach told People magazine that Perry thought the sport "was something that could help with his recovery." Perry had been very candid about his years-long addiction to alcohol and prescription painkillers in last year's best-selling memoir, Friends, Lovers, and the Big Terrible Thing.

Perry was publicly mourned by his Friends co-stars, Jennifer Aniston, Courteney Cox, Lisa Kudrow, Matt LeBlanc and David Schwimmer. The Matthew Perry Foundation, which the actor was working on prior to his sudden death, launched on Nov. 3. It has the goal "identifying addiction as a disease, addressing the complex of stigmas that prevents individuals from seeking and accessing care, and fiercely advocating for better and more equitable treatment."

"When I die, I know people will talk about Friends, Friends, Friends," Perry wrote in his memoir. "But when I die, as far as my so-called accomplishments go, it would be nice if Friends were listed far behind the things I did to try to help other people. I know it won’t happen, but it would be nice."