Matthew Perry death: The tragedy of extreme addiction is that the body may never recover

Friends star Matthew Perry has died, aged 54. Photo / Getty Images

It was the “addiction memoir” that laid things bare. Last year, when Matthew Perry released Friends, Lovers and the Big Terrible Thing, it detailed his 27-year grapple with drink and drugs in unstinting detail: how he ended up on life support with a “2 per cent chance to live” after opioid abuse burst his colon, requiring five months of recovery in hospital and nine months using a colostomy bag.

That, on another occasion, mixing those opioids with a sedative stopped his heart beating “for a full five minutes”; there, too, were the 14 operations he had on his stomach, the period of erectile dysfunction, and the day when, after biting into a slice of toast, all his top teeth fell out (Perry carried them to his dentist in his jeans pocket).

By 49, more than half his life — and US$9 million ($15.5m) — had been spent in treatment facilities. That Big Terrible Thing was in fact not one entity, but many, often resulting in his drinking 14 triple shots of vodka or taking 55 prescription painkillers a day.

Friends stars David Schwimmer (left), Lisa Kudrow, Matthew Perry, Courteney Cox Arquette, Jennifer Aniston and Matt LeBlanc at the 54th Emmy Awards in Los Angeles where the show won Outstanding Comedy Series. Photo / AP

The youthful bounce of Perry’s early days as Chandler Bing, the sarcastic Friends stalwart who would become an international star, soon began shifting in ways that could not have been age alone. “When I’m carrying weight, it’s alcohol; when I’m skinny, it’s pills. When I have a goatee, it’s lots of pills,” he explained in his book of his changing appearance on the show.

It was so striking that the most commonly asked question his co-star Lisa Kudrow would receive about Friends, she wrote in the memoir’s foreword, was “how’s Matthew Perry doing?”

The answer, when it was released in November last year, appeared to be well. Terrified by his latest brush with death and the prospect of needing a permanent colostomy bag, Perry was 18 months sober and, for the first time, ready to admit the extremes his addictions had taken him to. “I feel better because it’s out,” he said. “It’s on a piece of paper” — one that, incredibly rarely for celebrity memoirs, he had written every word of himself.

“I wanted to share when I was safe from going into the dark side again,” he said in another interview. “I had to wait until I was pretty safely sober — and away from the active disease of alcoholism and addiction” to come clean. One reviewer called Friends, Lovers and the Big Terrible Thing “a scream of authentic pain”.

While deeply exposing, writing the book had made Perry “stronger in every way”. Yet the ostensibly stable world he had been navigating would provide the backdrop to his death on Saturday aged only 54, when he was found drowned in his jacuzzi, of a suspected cardiac arrest.

Perry had reportedly played two hours of pickleball that morning — a sport he had become so fond of as to build a court at his Los Angeles home — before his assistant returned to find him unresponsive.

No illegal drugs were found (though a police “mole” did report finding prescription drugs for chronic obstructive pulmonary disease and antidepressants at his home), and no foul play is suspected. His last photo (six days before his death) posted to Instagram, of himself in the water, headphones on, under the dark of the night sky, has taken on a haunting air.

Perry was cast in Friends in 1994 at the age of 24, the wry foil to his co-stars’ more cookie-cutter characters. The show would transform their lives, with each of its 10 series earning tens of millions of viewers; 52 million people tuned into the 2004 finale, the show’s success by that stage so fundamental to the zeitgeist as to earn its cast $1 million apiece an episode. Almost two decades since it concluded, Bing is routinely voted viewers’ favourite character.

Friends is considered one of the most loved sitcoms of all time. Photo / Supplied

As the show’s success soared, behind the scenes, Perry was struggling. He was first given prescription painkillers in 1997, after a jet ski accident on the set of Fools Rush In with Salma Hayek; within 18 months, he was taking 55 Vicodin a day — a cocktail so potent that he later admitted he couldn’t remember shooting three seasons of Friends. The more he took, the more he needed to take in order to replicate the buzz, taking to attending open-house viewings on Sundays and raiding owners’ medicine cabinets to remain topped up.

“It’s exhausting but you have to do it or you get very, very sick,” he said of the prospect of withdrawal. “I wasn’t doing it to feel high or to feel good. I certainly wasn’t a partier; I just wanted to sit on my couch, take five Vicodin and watch a movie. That was heaven for me.”

On set, things were becoming harder to conceal. While Perry said he was never high during filming, the effects of what he was doing the rest of the time made themselves known: he fell asleep during one scene, nudged awake by co-star Matt LeBlanc as he was due to say his line; his on-screen wedding to Monica (Courteney Cox) in 2001 wrapped with him being driven back to a treatment centre. “At the height of my highest point in Friends, the highest point in my career, the iconic moment on the iconic show — [I was] in a pickup truck helmed by a sober technician.”

There was the time Jennifer Aniston came to his trailer and told him his co-stars could smell the alcohol he was consuming in vast quantities; on another occasion, the cast confronted him in his dressing room. All had remained close in the 19 years since wrapping, with Kudrow last year describing Perry’s battle with “a hideous disease, and he has a tough version of it”.

The tragedy of his death after fighting so long to get clean highlights the toll drink and drug abuse can take on the body, even once abstinent. Common byproducts of excess consumption include liver disease such as hepatitis or cirrhosis, kidney damage, collapsed veins and bacterial infections, bowel disease, emphysema, and raised risk of aneurysms and stroke.

“Drink affects pretty much every organ in the body, but particularly the liver and the heart and the immune system,” explains David Nutt, professor of neuropsychopharmacology at Imperial College London and author of Drugs Without the Hot Air. “If you’ve damaged yourself [from excess drug use], you’ll almost certainly reduce your life expectancy, which is why it’s always better not to do that in the first place.”

Matthew Perry as Chandler Bing. Photo / Getty

Research published last year showed 22.35 million adults in the US (equivalent to 9.1 per cent) were living in recovery, but there are limited studies showing how organs readjust once consumption of toxic substances ends, with the prevailing theory being that some — but not all — damage can be reversed.

Researchers from Oregon Health & Science University in 2018 showed even limited exposure to cocaine could fundamentally alter neuronal circuits in the brain, while a 2021 paper from the journal Alcohol Research: Current Reviews found that after excess drinking, “damaged organs may regain partial function or even heal completely, depending on the extent of organ damage and whether there is relapse”.

Its authors noted, too, that alcohol-induced dilated cardiomyopathy — where part of the heart muscle becomes stretched, making it unable to pump blood as it should — was prevalent in those who drank to excess, and was “accompanied by a high incidence of cardiac morbidity and mortality”.

While ceasing substance abuse will inevitably improve any conditions it has caused, “the likelihood is you’ll probably get a bit better, but I don’t think you’ll fully recover”, says Nutt. A toxicology report concluded the same condition had afflicted George Michael, a heavy drink and drug user until his death in 2016, aged 53.

Perry knew well that curbing his use of drink and drugs was not the end of the road, with recovery being, as it is for all addicts, “a day-to-day process of getting better”. He cared deeply about helping others in its grip — certain that “if a selfish, lazy f***** like myself can change, then anyone can” — at one stage setting up a sober rehab facility, the Perry House, at his former Malibu home.

Dedicating his book to “all of the sufferers out there”, he began finding purpose in speaking out about what he had endured. “Sometimes, I think I went through the addiction, alcoholism and fame all to be doing what I’m doing right now, which is helping people.”

Sober, he wanted more for himself, too. At the time of his book’s release (which sold double the number of copies as Bono’s memoir), he spoke of how addiction had derailed his personal relationships. Long-term happiness had proved elusive, he said, “because I won’t allow myself to have it. I always think something’s going to go wrong”.

Following relationships with actresses who included Julia Roberts, Lizzy Caplan and Neve Campbell, he proposed to literary agent Molly Hurwitz in 2020 — while “high as a kite” on 1800mg of painkiller hydrocodone. They split soon afterwards; another missed opportunity to start the family he had craved.

“Had I done so, I would not now be sitting in a huge house overlooking the ocean, with no one to share it with save a nurse, a sober companion, and a gardener twice a week,” he wrote.

But optimism — perhaps induced by that sobriety — had by last year begun to creep in. “I think I’d be a great father,” he said in an interview around the time of his book’s release, mulling an altogether different role. “I’m feeling more confident and I’m not afraid of love any more.”