Matthew Perry was reportedly sober for 19 months prior to his death in October, according to his autopsy report, which listed his cause of death as acute effects of ketamine.

More details are coming to light about Matthew Perry‘s final moments.

The Friends star—who was found unresponsive in his hot tub Oct. 28—died due to the acute effects of ketamine, a dissociative anesthetic, according to the Los Angeles County Medical Examiner.

His death was ruled an accident, listed as drug and drowning related. In addition to drowning, other contributing factors were coronary artery disease and the effects of buprenorphine, which treats opioid use disorder.

Perry’s autopsy report, obtained by E! News Dec. 15, also noted that he was “reportedly clean for 19 months” prior to his death at age 54.

The report states the Whole Nine Yards actor had a history of diabetes and emphysema, though he had given up smoking after being a “heavy tobacco user for many years.” He was also on ketamine infusion therapy, which is used to help with anxiety and depression, with most recent therapy reportedly occurring one and a half weeks before his death.

However, the medical examiner stated that the ketamine in his system could not be from the infusion therapy, because the drug doesn’t last that long in the body.

“At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular overstimulation and respiratory depression,” the report states. “Drowning contributes due to the likelihood of submersion into the pool as he lapsed into unconsciousness.”

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A year before his passing, Perry got candid about his sobriety journey in his memoir Friends, Lovers and the Big, Terrible Thing, including how he spent more than $7 million trying to get clean. While promoting the book in October 2022, Perry told The New York Times he had been clean for 18 months.

“There’s been some real up and downs in my life,” Perry shared with E! News the following month, “and this is a lot about the downs, but the further down you go, the more people you can help.”

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To see how Hollywood is honoring the Fools Rush In actor, read on for all the touching tributes.

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Molly Hurwitz

“He would love that the world is talking about how talented he was. And he really was very talented. As the Friends reunion was approaching, we rewatched the show together. ‘F–k, I was so good!!!…See what I did there???’ We rewound and studied scenes. Our respect and appreciation of humor is something that connected us. Being with him as he rediscovered his brilliance was magical. But, I obviously knew that man in a very different way, too. While I loved him deeper than I could comprehend, he was complicated, and he caused pain like I’d never known. No one in my adult life has had a more profound impact on me than Matthew Langford Perry. I have tremendous gratitude for that, for everything I learned from our relationship. I’d be remiss if I didn’t mention Al Anon, an invaluable resource for those who love someone struggling with this destructive disease. Matty, I feel relief that you are at peace.Sincerely,Moll-o-Rama(…fication).”

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Jennifer Aniston, Courteney Cox, Lisa Kudrow, Matt LeBlanc & David Schwimmer

“We are all so utterly devastated by the loss of Matthew. We were more than just cast mates. We are a family. There is so much to say, but right now we’re going to take a moment to grieve and process this unfathomable loss. In time we will say more, as and when we are able. For now, our thoughts and our love are with Matty’s family, his friends, and everyone who loved him around the world.”

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Bradley Whitford

“Matthew Perry made me laugh. Hard. You have not lived until you havewitnessed one of his in-between-the-takes confidential riffs on the absurdity of show business and the idiocy of male confidence, wrapped up perfectly with the sudden realization that we were both grown men who wear makeup for a living. Without substances, Matt had a huge, open heart and a pyrotechnical, joyous brain. I think the most beautiful parts of Matt made him the most vulnerable to the monster that he would have to fight for the rest of his life. His battle was heroic. They don’t have award shows for that. They should. Matt was full of contradictions. He was hilariously self deprecating and insecure and wildly self confident. He was a fountain of light with a huge capacity for darkness. He was profoundly blessed and terribly cursed.I want his parents to know that Matt was kind. Not just to his costar. To everyone. To honor Matt, I hope we can continue the work that mattered most to him: to open our hearts to so many who share his vulnerabilities, to encourage them to get the help they need, and to give them the love and the support they deserve. I’m so grateful that I had the opportunity to work with Matt, to spend some precious time with him, and most of all, to be his friend.”

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Ben Winston

“I feel so unbelievably lucky to have been able to make that reunion show with six truly remarkable people, witnessing their precious unbreakable bond with each other. Spending time with Matthew was simply a dream come true. Kind, caring… and a comedic genius.”

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Gwyneth Paltrow

“I met Matthew Perry in 1993 at the Williamstown Theater Festival in Massachusetts,” Gwyneth Paltrow wrote in a tribute on Instagram. “We were both there for most of the summer doing plays. He was so funny and so sweet and so much fun to be with. We drove out to swim in creeks, had beers in the local college bar, kissed in a field of long grass. It was a magical summer. He had shot the pilot of Friends but it had not aired yet. He was nervous, hoping his big break was just around the corner. It was. We stayed friends for a while until we drifted apart, but I was always happy to see him when I did. I am super sad today, as so many of us are. I hope Matthew is at peace at long last. I really do.”

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Adele

During Adele‘s Oct. 28 concert in Las Vegas, which took place just hours after Matthew’s death was confirmed, she paused her show to honor him, recalling the impact he had on her childhood. “One of my friends, Andrew, when I was 12 did the best Chandler impression,” she told the crowd. “And he would do it all the time to make us laugh. And if anyone was having a bad day or feeling low, he would just pretend to be Chandler. And I’ll remember that character for the rest of my life.”

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Maggie Wheeler

Maggie Wheeler, who played one of Perry’s most memorable love interests on Friends, wrote on Instagram, “What a loss.The world will miss you Matthew Perry . The joy you brought to so many in your too short lifetime will live on. I feel so very blessed by every creative moment we shared.”

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Salma Hayek

After his passing, Perry’s Fools Rush In costar Salma Hayek noted it took a “couple of days to process this profound sadness.”

“There is a special bond that happens when you share dreams with someone, and together you work towards them,” she wrote in an Oct. 30 Instagram post. “I was very moved last year when Matthew shared on his Instagram stories how much he loved ‘Fools Rush In,’ and how he thought that that film we did together was probably his best movie.”

“Throughout the years, he and I found ourselves reminiscing about that meaningful time in our lives with a deep sense of nostalgia and gratitude,” she continued. “My friend, you are gone much too soon, but I will continue to cherish your silliness, your perseverance, and your lovely heart. Farewell, sweet Matthew, we will never forget you.”

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Ione Skye

Alongside her final texts with Matthew days before his death, his former costar Ione Skye wrote on Instagram, “My last exchange a week ago. I’m very very sad. Loved this guy.”

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Kathleen Turner

Kathleen Turner, who played Chandler Bing’s parent on Friends, told People, “He had a good sense of humor and a good heart. He liked other people, which, to me, is terribly important, especially for an actor.”

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Shannen Doherty

The Beverly Hills, 90210 star remembered her time spent with the Emmy nominee.

“Matt always had THAT sense of humor,” she wrote on Instagram. “Matt and I had a date and it was on Valentine’s Day. He wanted to get a reservation at a restaurant in Malibu but couldn’t so my dad got the reservation for him. We went and he talked about my dads Irish persuasiveness the majority of the night. Our friendship spanned a long time. A lifetime really. I know many are hurting, especially our little gang. He will be missed by many and definitely by us. Yes. I could be more poetic or say things better but right now, shock and sadness prevail.”

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Morgan Fairchild

Morgan Fairchild, who played Chandler Bing’s mother on Friends, paid tribute to her onscreen son, captioning a social media post, “I’m heartbroken about the untimely death of my ‘son’. The loss of such a brilliant young actor is a shock. I’m sending love & condolences to his friends & family, especially his dad, John Bennett Perry, who I worked with on Flamingo Road & Falcon Crest.”

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Rumer Willis

The Whole Nine Yards actress, who worked alongside dad Bruce Willis and Perry during the 2000 film, shared a touching tribute after Perry’s passing.

“I’m so sad to hear about Matthew Perry passing,” she captioned an Instagram post. “When I was a kid and I was on set while he and my dad were doing whole nine and whole 10 yards he was so kind and funny and sweet with my sisters and me and I think his physical comedy and that movie still makes me laugh so much, I know he had many challenges in his life and brought a lot of joy to people with his comedy I hope he can rest peacefully.”

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Paget Brewster

Paget Brewster, who played the role of Kathy in the fourth season of Friends, remembered the time spent alongside the actor on set.

“I’m so very sad to hear about @MatthewPerry,” she wrote on X. “He was lovely to me on Friends and every time I saw him in the decades after. Please read his book. It was his legacy to help. He won’t rest in peace though.. He’s already too busy making everyone laugh up there.”

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Yvette Nicole Brown

Perry’s Odd Couple costar reflected on his legacy, sharing a statement to social media.

“Our #OddCouple family suffered a great loss today,” she wrote on X, alongside a photo featuring the cast. “The entire entertainment world has. I am too sad about the news to say more than this: @mattyperry4 was a sweetheart who deserved more peace in this life. 54 is too young to go. We love you, Matty! #RIPMatthewPerry.”

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Olivia Munn

The Violet star praised the actor for opening up about his sobriety journey after his passing.

“He struggled so much with addiction and was brave enough to be open and honest about it,” Olivia Munn wrote on Instagram Story Oct. 28. “I’m so sorry to his family and friends who are getting this news today. Nothing short of heartbreaking.”