STIGMA, Part 2: Matthew Perry, Addiction, Secrets, and Shame

Matthew Perry, 54-year-old Friends actor, was found dead in his pool spa on Saturday, Oct. 28, 2023.The autopsy results, released Friday, state he died from the acute effects of the anesthetic ketamine. “Perry’s cause of death was not from his prior (ketamine) infusion therapy (for depression and anxiety) but rather ketamine (in his blood) that was taken in another manner. How that happened, the autopsy report said, is unknown.” (1)

My heart sank as I read this news report. Another smart, funny, talented person no longer on this earth due to addiction. I was further saddened as I read about Perry’s life and struggle with addiction and the stigma and shame associated with it.

In his memoir, Friends, Lovers and the Big Terrible Thing released November 2022, Perry said, “I had a secret and no-one could know…I loved everything about the show (Friends) but I was struggling with my addictions which only added to my sense of shame.” Friends co-star, Jennifer Anniston, said that she texted with Perry on the day of his death. “He was happy. He was healthy. He had quit smoking. He was getting in shape…He was not in pain. He wasn’t struggling. He was happy.” (2) How is it that someone who appears happy to his friends ends up overdosing on ketamine within a few hours? (I do not want to be presumptuous in assuming Perry self-administered the lethal drug that ended his life. It is always possible that something nefarious happened by someone who would benefit from his death, but to my knowledge, that possibility has not yet been explored.)

I know from first-hand experience how this can happen. Our 25-year-old son, JL, had been in recovery for 6 months and by all appearances to us, his friends, and the people at the recovery program, he was doing great. But within 24 hours of moving into an apartment, he was dead from a heroin overdose. His friend and neighbor said that they had been drinking with friends and the last he saw JL was when he went to bed at 4am. What he, and we, didn’t know was that after having his wisdom teeth extracted a few weeks previously, he had relapsed and moved on from the prescribed pain pills to several days of being back on heroin.

People struggling with addiction necessarily keep secrets from those around them, even — or especially — those they love. Some of the reasons relate to not wanting to hurt or disappoint their loved ones one more time while some is due to the shame and stigma related to their struggles. Perry relates in his memoir he had an addictive personality. Drinking by the age of 14, he progressed to consuming huge volumes — alone. After taking one painkiller for an injury, it escalated to 55 pills a day within 18 months. Sounds familiar for our son and for millions of others worldwide.

Prevention is the best weapon we have to fight against the epidemic that is taking the precious lives of over 100,000 people every year in the USA. The WHO reports that worldwide, in 2019, about 600,000 deaths were attributable to drug use. Close to 80% of those deaths were related to opioids. (3) These figures have increased exponentially since 2019 due to the proliferation of novel opioid-like synthetic drugs. Our politicians need to ramp up the efforts of working to stop the immoral manufacture and exportation of addictive drugs in illicit labs in China and Mexico — along with the promotion of prescription opioids by big Pharma. Then there is the issue of demand…

Those drugs would have limited consumers if we focus our attention on clearly and openly teaching our children about drug and alcohol addiction from an early age and continuing the dialogue as they mature and experiment. And yes, some of our own children will become the 20% who find that among all of their friends that try the same drugs at a party, they are the ones who can’t just walk away. But they would know they can come to us without shame and stigma and ask for help. Let’s take the allure out of illicit drug use by moving the discussion out of the dark world of secrets into the light of truthful information.

Hazelden Recovery says their “fundamental addiction stigma-smashing strategy is to shine a light on people who are in recovery and expose the reality that people actually do recover from addiction; that it’s a chronic disease that can be successfully managed for life; and that it affects individuals who are every bit as moral, productive, intelligent, talented — and humanly flawed — as the next person.” (4) Just like you and me.

Light seems to be the best answer to the deceptive and soul-destroying and self-destructive dark world of secrets and addiction.

References:

1) https://www.cbsnews.com/news/matthew-perry-cause-of-death-ketamine/

2) https://variety.com/2023/tv/news/matthew-perry-cause-of-death-ketamine-1235772053/

3) https://www.who.int/news-room/fact-sheets/detail/opioid-overdose

4) https://www.hazeldenbettyford.org/recovery-advocacy/stigma-of-addiction

In Dr. Jana Burson’s blog about stigma she cites one doctor who is pro-stigma, saying it is “a good thing because stigma discourages deviant behavior and has a civilizing effect on society… and people with substance use disorders are irresponsible.” This doctor said of people who relapse back to drug use repeatedly “it is a behavior almost always under one’s control…” Dr. Burson says, “Loss of control over substance use is one of the hallmark criteria for the diagnosis of substance use disorder.” See her blog for the remainder of this important discussion. https://janaburson.wordpress.com/2018/07/16/stigma-and-substance-use-disorders/

The AMA and Am. Society of Addiction Medicine (ASAM) have a good article on stigma:

https://www.asam.org/resources/publications/magazine/read/article/2015/12/15/patients-with-a-substance-use-disorder-need-treatment---not-stigma