Chandler Bing of the TV show “Friends” was known by viewers as a jokester—it was his most funny and endearing quality. How ironic that, beyond the glare of the camera, he was a tortured soul who ingested alcohol and drugs to sustain his psychic equanimity. In his memoir Friends, Lovers, and the Big Terrible Thing, he wrote about his deep sense of loneliness and childhood insecurity after his parents divorced and his father’s absence from his life.
Perry found fame and wealth in his adult years. His struggles nonetheless mirrored those at all levels of the social order. Take Ernie, for example, a defendant I evaluated, who was charged with felony assault with a deadly weapon. He had been homeless for years, and used methamphetamines to get high, “so I could feel alive.” Meth lifted him into a state of hedonic excitement and pleasure, at first. With increasingly heavy use, he became increasingly agitated and paranoid to the point that his perceptual distortions could trigger a psychotic-like rage.
To avoid the latter phase of his addictive cycle, Ernie began using fentanyl, and then ketamine, whenever he felt meth’s pleasurable rush transforming into demonic derangement. Fentanyl is a synthetic opioid and ketamine is an anesthetic. Both drugs are sedating, but ketamine has potent dissociative effects that leave the user in a state far removed from inner emotional turmoil. These drugs also lower frustration tolerance and heighten irritability. It’s a paradoxical reaction similar to how antidepressant medication could cause depression or even suicidality.
Ernie was a high-volume drug user – whether it was Ketamine or meth. One night, after two days of meth abuse with a ketamine kicker, he smashed a beer bottle across a man’s head during an argument at a homeless encampment. He was facing an assault with a deadly weapon charge.
Matthew Perry had reached the heights of wealth and prominence and was a beloved celebrity. Ernie was financially impoverished, homeless, and a violent drug abuser who was viewed by many with contempt. Yet both had a lot in common. Ernie, like Perry, was raised by a single mother whose father abandoned the family. Ernie’s early life became even more fractured after his mother’s boyfriend moved in with them. An alcoholic, he was emotionally abusive to Ernie and physically assaultive to his mother, who nonetheless catered to her lover and increasingly neglected her son.
By the time Ernie was in high school, his attendance was irregular at best, and he dropped out at the age of 17. In no time, he was living on the streets. With no job skills or education, he became deeply ensconced in street life and its drug culture, up to his assault arrest.
The abuse of drugs like fentanyl and ketamine has been on the rise in America, which has led to an alarming increase in overdose deaths. Fentanyl abuse is a particularly potent risk factor for death. Ketamine is less lethal but could have lethal effects. Ketamine is used by anesthesiologists during surgery and by psychiatrists for the off-label treatment of intractable depressions. It has also become widely fashionable as a recreational drug of abuse among those in all social strata, as the death of Perry has made tragically clear.
A psychologically significant characteristic of Ketamine is its dissociative effect, leaving users in a state far removed from psychological life. It allows one to disconnect from chronic emotional pain. Interestingly, Ernie told me Ketamine afforded him an escape from his memories and the reality of his life. He didn’t concern himself about its dangers. Though rarely suicidal, he cared less if he lived or died. His heedless use of dangerous drugs was like a game of Russian roulette as he tempted fate. It was a passive form of suicidality. His drug abuse was both an escape from his reality and an expression of a tormented psyche. His need to escape was born out of an emptiness, an emotional void that’s hard to live with.
Together, Ernie’s plight and Matthew Perry’s death provide a window into the socially overarching widespread nature of the abuse of drugs like ketamine and fentanyl. Perry wrote about how his early life created a deep sense of loneliness and insecurity that he struggled to cope with by any means possible. His talent as a comedian brought him social validation. But such recognition clearly couldn’t compensate for an inner emotional hole that stemmed from childhood deficits in bonding and emotional security. Perry’s psychological struggles were similar to Ernie’s, with both concluding that the use of an analgesic to kill pain and to detach from inner torment was the preferred form of palliative care. Although Perry and Ernie’s outer lives took very different and distinct trajectories, their inner struggles were parallel, intending to manage the unmanageable void within themselves.
A fraught early life leaves one vulnerable to an adulthood of isolation, despair and self-destruction, as we have seen with Ernie and Matthew Perry. But there are other pathways as well. Explosive technological advances and the loss of manufacturing jobs have eroded available opportunities for good-paying employment without a college education. These changes have especially hit working-class men who are faced with employment problems and chronic financial instability. Most tragically, many suffer from a sense of being superfluous, socially discarded, desperate, and hopeless. The abuse of ketamine is a way of dissociating from such a painful state of being, if only for a while. Not unlike Ernie or Matthew Perry, these men who died from overdoses were engaging in a passive form of suicide or, as described by researchers, they were victims of “death by despair.”
That’s also a way of characterizing Matthew Perry’s long and public battle with personal despair and drug abuse. His state of mind was certainly reflected in Ernie’s expression that ketamine abuse afforded an escape from life.
