Dear Editor,

I read the sad news about the death of one famous actor, Matthew Perry, from ketamine addiction and overdose. The initial investigation indicates that ketamine made it into the streets of America and is available in the black market. In the past two decades, anesthetic drugs have made the streets of America and taken human lives, as in the case of the famous singer Michael Jackson intoxicated with Diprivan (propofol) commonly used sedative-hypnotic in the operating room, and recently, actor Matthew Perry with Ketamine hydrochloride.

Back in 2005, I wrote a letter to the editor warning about the liberal use of narcotics before the opioid crisis, and this time, I am writing a similar letter to the editor warning against ketamine’s liberal use.[ 1 ]

The Drug Enforcement Administration lists ketamine as a hallucinogen. It is referred to as a “dissociative anesthetic hallucinogen.” Ketamine got its start as an anesthesia medicine for animals in the 1960s. The Food and Drug Administration (FDA) approved it as an anesthetic for humans in 1970, according to WebMD. Ketamine has long been used as an anesthetic in veterinary medicine! Ketamine is an excellent anesthetic drug with strong analgesic properties in addition to sedative hypnotic features.

After the opioid crises and abuse, there was a push for a non-opioid based anesthetic regimen. This has led to the liberation of ketamine use and is being used as an integral anesthetic to so called “opioid free anesthesia and analgesia” part of enhanced recovery after surgery. It has been introduced as part of a safe anesthetic regimen and partly to prevent the initial steps of opioid addiction while enhancing recovery!

Unsurprisingly, recreational ketamine use and availability of the drug have increased in recent years!! Especially true since the FDA approval of ketamine for psychiatric use in 2019; there has been substantial attention and media coverage about the drug! As a “club drug,” ketamine use has always been closely linked with ecstasy use, which is also most likely to take place in nightlife settings! It coincides with potential misuse and abuse of the drug and divided 2001 increases in ketamine use in nightclub and non-hospital settings!

Furthermore, over the years, ketamine clinics have spread all over the country, and several new indications have surfaced for the liberal use of ketamine as an answer for chronic pain syndrome, affective disorders, depression, migraine headaches – etc. Ketamine is becoming accessible and easy to obtain without tight supervision as its use extends beyond the operating room. Ketamine results in mental status alteration and mental intoxication of the human brain that might lead to ultimate demise. In the meantime, the literature is lacking regarding the overall benefits versus risks in the liberal use of potentially addictive drugs with features of misuse and abuse by the public!

Being a senior anesthesiologist, pain specialist, and neurosurgeon, I stayed away from prescribing ketamine and restricted its use only during intraoperative sedation and general anesthesia. I have noticed widespread naivety to the potentially toxic effects of ketamine and drug overdose as what had occurred with the liberal use of narcotics in the past.

It is the time to alert the public and restrain the liberal use of ketamine. Ketamine is not a benign drug, and there should have been much restriction on its use and avoidance of its liberal use of ketamine without supervision and quality control over the years!

Ketamine is mainly used as part of anesthetics during surgery with careful monitoring and available resuscitation equipment!

Ketamine, therefore, should join other addictive street drugs since it is not a benign drug and is highly addictive and can lead to overdose and subsequent death.

Actor Matthew Perry

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Use of artificial intelligence (AI)-assisted technology for manuscript preparation

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The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Journal or its management. The information contained in this article should not be considered to be medical advice; patients should consult their own physicians for advice as to their specific medical needs.

References

1. Ghaly RF, Aldret JA. Critical look at legalization of liberal use of high-dose narcotics: Is this a reality?. Surg Neurol. 2005. 64: 480-1 discussion 481-2