How Matthew Perry Misused Substances to Treat His Depression

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Inside Matthew Perry’s Co-Occurring Disorders and How He Misused Substances to Treat His Depression

Launched in 2013, the harris project is a nonprofit dedicated to the prevention and treatment of co-occurring disorders (COD) — the combination of mental health challenges and substance use issues. Us Weekly has partnered with the harris project to bring you The Missing Issue, a special edition focusing on the stories of celebrities who struggled with COD.

To the people who spent time with him, Matthew Perry could instantly change the energy in a room, light it up and leave it laughing. To the millions who came to love him as his quick-witted, sarcastic but sweet character Chandler Bing on the sitcom smash hit Friends, he was handsome, charming and funny — and magnetic enough to influence pop culture forever with his iconic inflections that couldn’t be anyone else’s.

And yet, when he was found unresponsive in his hot tub on Oct. 28, 2023 — and pronounced dead later that day — even before the world knew the official cause of the 54-year-old star’s death, his friends worried it was a drug overdose. In a story posted by Us Weekly in December 2023, those closest to the actor said he’d “been struggling with sobriety for years,” and that “every time he fell off the wagon there was a huge sense of shame.”

“After Friends ended there was a lot of depression and disappointment in his career,” a Perry insider told Us. “He struggled with his mental health but never got help for it. The way he dealt with that was to isolate. Since the show, he was financially taken care of and didn’t have to work, so it created an environment to use.”

Perry’s official cause of death was determined to be “the acute effects of ketamine,” according to a December 2023 report by the Los Angeles County Medical Examiner. The report also listed drowning, coronary artery disease and the effects of buprenorphine — a medication used to treat opioid use disorder — as contributing factors in his accidental death.

In his bestselling 2022 memoir, Friends, Lovers, and the Big Terrible Thing, Perry said he had been in rehab 15 times. He often talked about struggling with feeling depressed and his inability to deal with being alone — something the 20+ million Americans diagnosed with co-occurring disorders can often relate to.

“Left alone my crazy brain … would find some excuse to do the unthinkable: drink and drugs,” he wrote. “In the face of decades of my life having been ruined by doing this, I’m terrified of doing it again. I have no fear of talking in front of twenty thousand people but put me alone on my couch in front of a TV for the night and I get scared.

“I am constantly filled with a lurking loneliness, a yearning, a clinging to the notion that something outside of me will fix me. But I had all that the outside had to offer!”

Chris Polk/FilmMagic
He Struggled to Keep Meaningful Connections
For Perry, depression was a mental health challenge he talked about often and was working to address; his deep and ongoing fear of being alone was a trigger for substance use that he didn’t seem to know how to fight, and substance misuse, he knew, was destroying his body.

During season nine of Friends, he writes, he was sober for two years (and got nominated for an Emmy for Outstanding Lead Actor in a comedy). In his book, Perry said that during his struggles he thought, “I’m capable of staying sober unless anything happens.” Drugs and alcohol became essential when he was facing something he didn’t think he could handle. It was in the midst of a tumultuous breakup with a woman he was seeing that “something happened,” he wrote. She began crying uncontrollably and went into the bathroom, leaving him alone in her hotel room, feeling helpless to make the situation any better. On her bedside table was a knocked-over bottle of Vicodin. He took three pills “and somehow made it through the night,” ending his two-year run of sobriety.

Perry wrote about how he had sabotaged multiple relationships with wonderful women and was riddled with regret. “I met at least five women I could have married, had children with,” he wrote. “Had I done so just once, I would not now be sitting in a huge house, overlooking the ocean, with no one to share it with, save a sober companion, a nurse and a gardener twice a week.” He wrote about dating Natasha Wagner, Natalie Wood’s daughter, and said she was “beautiful, smart,” and “had it all.” Years after their relationship ended, she called to tell him she’d welcomed a baby girl. He wrote that when the call was over, he was overcome with emotion: “’She could have had that child with me,’ I said, to no one, as I sobbed like a newborn myself. I was so sad and alone.”

That hole he felt due to never becoming a husband or father was painful. “A big part of sadness in his life is also that he didn’t have children,” the same source told Us in December 2023. “He wanted a family and he never found that person to settle down with and he was lonely.”

Though he uses the word “alone” over 50 times in his memoir, writing about his fear and pain when alone and his enduring emptiness and anxiety connected to being alone, he doesn’t mention that any of the treatment he received addressed that fear.

He Sought Help and Treatment Repeatedly
Perry wrote in his memoir that he’d spent close to $7 million on rehabilitation and treatment for substance misuse. In a subsequent interview with The New York Times, he said that number was close to $9 million. Despite his colon bursting from opioid misuse — at one point he was taking as many as 50 Vicodin a day — and spending months in a coma, then nearly a year with a colostomy bag, Perry began to misuse the very drug (ketamine) that he was taking to treat depression.

His half-sister, Caitlin Morrison, in an interview on Today a year after Perry’s death, said his struggle with substance misuse was complicated and layered. “It’s a hopeless thing to be in that place where you’re in a constant battle between wanting to be free and your brain and your body are trying to rope you back into, you know, being a slave, essentially,” she said in October 2024.

Courtesy Everett Collection
Recognizing Co-Occurring Disorders
In the last days before his death, Perry was “happy,” his stepfather Keith Morrison said in a March 2024 interview on Hoda Kotb’s Making Space podcast. He was texting often with his mom, Suzanne, and wanted to be an advocate for others struggling with sobriety. (After his death, his family has launched The Matthew Perry Foundation to help others fighting substance misuse, something that was hugely important to him.)

Perry talked a lot about that desire in his memoir and also expanded on it during an interview with Tom Power at the Hot Docs Ted Rogers Cinema in Toronto before a live audience in November 2022, where he discussed the memoir and his co-occurring disorders and told people struggling that they should not give up. “Raise your hand if you’re suffering,” he said. “As for help, don’t let it be a secret.”

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Focusing on co-occurring disorders could be beneficial for all the people that he wanted to help by sharing his story. When asked how he would like to be remembered, he said, “As somebody who lived well, loved well, was a seeker and his paramount thing is that he wants to help people. That’s what I want.”

To purchase The Missing Issue for $8.99 go to https://magazineshop.us/harrisproject.

If you or someone you know is struggling with mental health and/or substance use, you are not alone. Seek immediate intervention — call 911 for medical attention; 988 for the Suicide and Crisis Lifeline; or 1-800-662-HELP for the SAMHSA (Substance Abuse and Mental Health Services Administration) National Helpline. Carrying naloxone (Narcan) can help reverse an opioid overdose.