We have all heard that Matthew Perry died in October of 2023. We have all heard that ketamine was the involved in his death. We all heard that two of Matthew Perry's doctors were arrested and plead "not guilty". Did you know that these doctors is still practicing and prescribing ketamine?
The doctors' names are "Dr. Salvador Plasencia, 42, a.k.a. "Dr. P," of Santa Monica, and Dr. Mark Chavez, 54, of San Diego." These doctors prescribed ketamine to a self proclaimed drug addict for home use. I'm not talking about home use of ketamine troches. They prescribed IV ketamine to be administered via injection at home in dosages way too high for home use. These doctors, who .in my opinion, are still a threat to the public, are still allowed to practice medicine. They lost their DEA certification and can't prescribe any controlled substances. These doctors took advantage of Matthew Perry's addiction issues. They saw him as a cash cow.
This dramatically differs from my experience with physician prescribed ketamine for CRPS pain and/or mental health issues. When I received ketamine for the first time, it was in Germany for a ketamine induced medical coma. I was in an ICU hooked up to cardiac monitors, an ART line (arterial lines) to draw blood gases and directly monitor blood pressure and one on one ratio of nurse to patient, This is what is medically necessary for a very high doses (anesthesia level) of ketamine. If something had gone wrong, they had medical staff to either stop the ketamine and/or administer drugs to reverse the situation.
My outpatient ketamine, done in a clinic setting, also involved monitoring by a nurse. I was hooked up to a heart monitor, respiratory monitor, BP cuff, and pulse oximeter to monitor my oxygen. At first I did low dose Ketamine with Dr Robert J Schwartzman at Hahnemann Hospital clinic. We were instructed not to drive, swim or sign any legal documents or engage in any other activity that we could injure ourselves or others for 24 hours just like any other anesthesia. After Dr Schwartzman retired, I began seeing Dr Ashraf Hanna in his Clearwater Clinic. Again I was monitored by a nurse using a heart monitor, breathing monitoring, BP monitoring and a pulse ox. Again, I was instructed to just rest over the next 24 hours. I was instructed not to drive, sign any legal documents or partake in an activity where I could injure myself or others.
Home use ketamine came to my attention in 2012. These are sublingual lozenges. They are at a substantially lower dose that the IV ketamine. Additionally, the absorption is far less with the sublingual as compared with IV. I was instructed not to drive, swim, or make important decisions after taking the lozenge. I took them at bedtime. I would have never considered driving or going into a hot tub or pool. If these instructions were given to Matthew Perry, which I doubt because no responsible physician would give a patient access to IV ketamine in the amounts he received, then Mr Perry put himself at risk. These two doctors were not selling him ketamine at the rates that doctors can obtain it. They gave him access to huge amounts of ketamine, with no medical monitoring, to inject. They were taking advantage of him and his addiction!
Ketamine has been a viable treatment for those with CRPS in the US since 2003 thanks to Dr Robert J Schwartzman. Dr Schwartzman did not require cash payment. He accepted the CRPS patient's health insurance.
More recently, ketamine has been being used for mental health issues such as drug resistant depression, OCD, PTSD and anxiety, I found that added benefit while getting ketamine for CRPS. Once the mental health studies on ketamine were published, ketamine clinics started popping up everywhere.
The publicity about Matthew Perry's death has already affected ketamine for legitimate pain and mental health providers. The DEA (Drug Enforcement Agency) has been doing site visits at ketamine clinics looking at safety measures, patient medical records, etc. If you are using a qualified anesthesiologist/pain management doctor, your ketamine clinic should be able to continue. I expect scrutiny of ketamine clinics will continue.
Before Matthew Perry's death, some physicians accepted health insurance as payment. There have always been physicians who require cash payment for their services. Perhaps they think that if they aren't billing insurance that they will stay under the radar of the DEA. Another reason for not accepting insurance is that insurance does not pay very much to the treating physician. The ketamine physician has to pay for the monitoring equipment, the medications (ketamine is cheap but other medications are used) and the nursing care. It is very possible that for some ketamine physicians, insurance reimbursement does not cover their costs.
I think that we have not heard the end of the Matthew Perry case. There were 5 people arrested and because Matthew Perry was loved by so many, there will be continued negative publicity regarding ketamine. I will be publishing a post about questions to ask when you are interviewing a ketamine clinic.
When it came to decongestants, cough medicines and now ketamine, it seems that the abusers make things difficult for the people who legitimately need this medication because of those who abuse it.
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