The image of Matthew Perry is forever burned into our collective memory as Chandler Bing, the king of the one-liner who could make a simple sentence like "Could I be any more...?" into a cultural phenomenon. But on October 28, 2023, the laughter stopped. He was 54.
He was found face down in the heated end of his pool—effectively a large hot tub—at his home in the Pacific Palisades.
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Honestly, the news hit like a physical weight. We’d all read his memoir, Friends, Lovers, and the Big Terrible Thing. We knew he’d struggled. We thought he was finally on the other side of it. But when the autopsy report from the Los Angeles County Medical Examiner dropped, the narrative shifted from a tragic natural passing to something far more complex and, frankly, infuriating.
The Reality Behind the Matthew Perry Hot Tub Findings
Most people hear "Matthew Perry hot tub" and assume he simply had a heart attack or slipped. That’s not what happened.
The official cause of death was the acute effects of ketamine.
Now, ketamine isn't just a "party drug" or a "horse tranquilizer," though it has those reputations. It’s a powerful dissociative anesthetic. Perry was actually undergoing legal ketamine infusion therapy to treat depression and anxiety. His last official session, however, was a week and a half before he died.
Here is the kicker: Ketamine has a half-life of only about three to four hours.
The levels found in Perry's blood were massive. We’re talking 3,271 ng/mL. For context, when you’re under general anesthesia for a major surgery, your levels might be between 1,000 and 6,000 ng/mL. He had enough of the drug in his system to lose consciousness completely.
Why the water was the real killer
Ketamine by itself rarely stops someone from breathing. Unlike opioids, it usually leaves your "airway reflexes" intact. You don't just stop.
But Perry was in a hot tub.
When you're that dissociated and sedated, you lose "postural control." You can't keep your head above water. The Medical Examiner, and several independent toxicologists like Dr. Andrew Stolbach from Johns Hopkins, noted that if Perry hadn't been in the water, he almost certainly would have lived through that dose.
The hot tub turned a state of high sedation into a death trap.
Contributing factors included:
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- Drowning (the secondary cause).
- Coronary artery disease (which made his heart less able to handle the stress).
- Buprenorphine (a medication used to treat opioid addiction, which was in his system at therapeutic levels but can add to respiratory depression).
The "Ketamine Queen" and the Criminal Web
For months, we wondered where the drug came from. If his last doctor-supervised appointment was ten days prior, how did he have surgical-grade levels in his blood?
The investigation blew the lid off a "broad underground criminal network."
It turns out Perry's own live-in assistant, Kenneth Iwamasa, was the one who found him. But Iwamasa wasn't just an assistant; he admitted to injecting Perry with ketamine multiple times on the day he died.
He wasn't a doctor. He had no medical training.
The trail led to two doctors, Salvador Plasencia and Mark Chavez, and a woman the DEA calls the "Ketamine Queen" of Los Angeles, Jasveen Sangha. Plasencia allegedly texted Chavez, "I wonder how much this moron will pay," referring to Perry. They were selling him vials that cost $12 for $2,000.
It was predatory.
By late 2025 and into early 2026, the legal dominoes finally fell. Sangha, the "Ketamine Queen," pleaded guilty to five federal charges, including distribution resulting in death. She’s looking at decades in prison. Plasencia and the others also took plea deals. It wasn't just a tragic accident; it was a systemic exploitation of a man who was clearly spiraling.
Why This Matters for Hot Tub Safety
You might think this is just a "celebrity problem." It's not.
The combination of heat and any sedative—alcohol, Benadryl, prescription meds—is incredibly dangerous. Heat dilates your blood vessels. Your blood pressure drops. You get "orthostatic hypotension," which is that woozy feeling when you stand up too fast.
Add a dissociative drug like ketamine to that mix, and you don't even realize you're slipping under.
Real risks you need to know:
- Temperature spikes: Never set a hot tub above 104°F. Even then, 15–20 minutes is the limit.
- Solitary soaking: If you are using any medication that causes drowsiness, never soak alone. Perry’s assistant had gone out to run errands. Had someone been there, he might be alive today.
- The "Trance State": Doctors call the ketamine effect a "K-hole" in recreational terms. In medical terms, it’s a trance. You are awake but disconnected. You cannot save yourself from drowning in six inches of water in that state.
What We Can Learn From the Tragedy
The Matthew Perry hot tub story is a dark reminder that "legal" treatments can be dangerous if moved outside a clinic. Ketamine therapy is helping thousands of people with treatment-resistant depression. It’s a medical breakthrough. But it belongs in a doctor's office with a pulse oximeter on your finger and a nurse by your side.
Perry was seeking relief. He was a man in pain who was taken advantage of by people who saw a "Friend" as a piggy bank.
If you or someone you know is exploring ketamine therapy, ensure it is through a board-certified clinic. Never take "take-home" doses of ketamine unless they are low-dose troches specifically prescribed and monitored, and even then, stay away from the water.
Next Steps for Safety and Awareness:
- Check your meds: Look at the labels for "do not operate heavy machinery." That includes your hot tub.
- Monitor therapy: If a loved one is undergoing infusion therapy, be present for the 24 hours following a session.
- Vet the clinic: Ensure any ketamine provider has emergency resuscitation equipment on-site. If they offer to sell you vials for home use, report them. It is illegal and deadly.