Friends star Matthew Perry died from “acute effects of ketamine,” the Los Angeles County Medical Examiner’s Office said today. The autopsy report also cited drowning, coronary artery disease and the effects of buprenorphine — a drug used to treat opioid use disorder — as contributing to his death.

Ketamine is a drug used recreationally that dulls pain, causes forgetfulness, intoxication, disassociation and euphoria. It is also increasingly used under medical supervision to treat depression. That application was approved by the FDA in 2019.

The manner of death was ruled an accident. Perry died October 28 at his home in the Pacific Palisades area of Los Angeles. He was 54.

Friends ran from 1994-2004, co-starring Jennifer Aniston, Courteney Cox, David Schwimmer, Matt LeBlanc and Lisa Kudrow. Perry played Chandler Bing on the Manhattan-set sitcom, which was one of the most-watched shows on U.S. primetime.

Perry had a well-documented history of abusing alcohol and prescription drugs, though he was believed to be sober at the time of his death. He detailed that struggle in his 2022 memoir, Friends, Lovers and the Big Terrible Thing, for which he did extensive interviews

“Hi, my name is Matthew, although you may know me by another name. My friends call me Matty. And I should be dead,” Perry wrote in the opening of the book.

Following Friends, Perry went on to star in three short-lived network television shows: Studio 60 on the Sunset Strip, Mr. Sunshine and Go On.

He also logged guest appearances or recurring roles in other hit TV shows, including The West Wing, Ally McBeal, Scrubs and Beverly Hills, 90210. His motion picture credits included Fools Rush In, The Whole Nine Yards, Almost Heroes and Three to Tango.