Legal experts weigh in on ketamine charges and why physician and assistant involvement is critical

News of arrests in the investigation into Matthew Perry's death reverberated through Hollywood and beyond on Thursday, as five people were charged in connection with the actor's fatal ketamine overdose. As a lawyer tells Yahoo Entertainment, the case has “some very unusual aspects.”

Of the five defendants, two are doctors, one was Perry's personal assistant and two are suspected drug dealers, including the so-called “Ketamine Queen” of Los Angeles. Legal experts say the high profile the case received was a driving force for the investigation.

“It is very rare to see a person [like Perry] that has such an intricate network that allows access to drugs. I don't think you get that kind of treatment unless you're very famous or very rich,” Harry Nelson, a health care attorney in LA who was involved in the Perry case and the investigation, tells Yahoo. “So I think it's unusual that there just aren't that many cases where [all investigative authorities] we will invest enormous resources here.”

Perry was found unconscious in the heated portion of his pool on October 28, 2023. A criminal investigation was launched after the Los Angeles County Coroner's Office determined that Perry died from “acute effects of ketamine.” The Los Angeles Police Department, Drug Enforcement Administration (DEA), U.S. Postal Service, and the U.S. Attorney's Office for the Central District of California investigated Perry's death.

Nelson was involved in several high-profile cases, including that of Michael Jackson, who died in 2009 from “acute propofol poisoning.” The case was ruled a manslaughter.

“It's very unusual to have a federal investigation, even when it involves controlled substances,” he says. “Usually it's local law enforcement, a local district attorney, not the federal government. This case got tremendous attention because it was a national media story, and again, there were unusual circumstances in terms of the number of people who enabled and abetted the things that actually killed Matthew Perry.”

Criminal defense attorney Lauren Johnson-Norris agrees, telling Yahoo that while “these charges are becoming more common,” it's likely that “more attention was drawn to Perry's notoriety, which led to the charges being brought against these individuals.”

“Many drug addicts overdose, but few people around them are willing to turn in the dealers,” Johnson-Norris explains. “In this case, it appears that Perry's assistant passed on that information. If prosecutors knew who was distributing the drugs that killed more people, they would certainly charge more overdose cases.”

Perry's assistant Kenneth Iwamasa pleaded guilty to conspiracy to distribute ketamine resulting in death. According to federal prosecutors, he admitted to “repeatedly injecting Perry with ketamine without any medical training.” He is accused of obtaining ketamine from two drug traffickers and a doctor, all of whom are among the defendants. Iwamasa administered the drug to Perry. Friends Star the day Perry died.

“The interesting thing about the assistants is that there is a whole network of people in Hollywood who are basically empowered to do all these things for the clients they serve – very powerful, rich, famous people,” Nelson says, noting that it is not uncommon for celebrity assistants to be “involved in [in] the medical care of their clients and organize, for example, the intake of medication.”

Before his death, Perry had undergone ketamine infusion therapy to treat depression and anxiety, which can be legally used by licensed physicians. In Thursday's press conference, the DEA said he became addicted to “intravenous ketamine” in the fall of 2023.

Court documents obtained by NBC News describe Iwamasa's consent agreement and reveal details of the hours before Perry's death. Iwamasa allegedly gave Perry an injection at 8:30 a.m. on October 28, 2023, and again at 12:45 p.m. while Perry was watching a movie. The actor allegedly instructed him to turn on the hot tub and give him “a big shot,” by which he meant ketamine. When Iwamasa returned from running errands, he found Perry facedown in the pool.

“I knew from the investigation that they were asking questions [about Iwamasa],” Nelson, author of The United States of Opioids, betrays.”[Investigators] “They requested subpoenas and wanted to know how many times he had answered the phone. They wanted to see text messages from him to see what role he had played.”

Nelson says this was “a very complicated situation where there were people around Perry trying to help him get what he needed medically, but in doing so they obviously crossed lines and enabled things that were questionable. It's really unusual for someone like Iwamasa to be drawn into this situation.”

Perry's friends and family were “surprised” and “saddened” by Iwamasa's arrest, Us Weekly reports. However, Johnson-Norris says she is “not surprised” that he was charged.

“[Iwamasa] is not excused because his boss ordered him to do something illegal. He is an adult and has to obey the law like everyone else. You can't give people illegal drugs just because they ask you to,” she explains. “It's too dangerous. In this case, it cost Perry his life.”

Iwamasa allegedly worked with Dr. Salvador Plasencia to obtain ketamine and learn how to inject the drug. Plasencia was arrested Thursday and faces multiple counts related to Perry's death. NBC News reports that Plasencia told a patient the week before Perry's death that he was “too far gone and in a downward spiral in his addiction,” according to court documents, but still offered to sell him ketamine through Iwamasa.

Dr. Mark Chavez was arrested and charged for allegedly selling Plasencia ketamine, but took a plea deal. Nelson says that in addition to major drug dealers, doctors were a “primary target” in this case because of their professional responsibilities.

Johnson-Norris adds: “We should all be shocked that doctors were involved in the illegal distribution of controlled substances to their patients. Doctors take [an] They took an oath to do no harm, but here they clearly took advantage of Perry's addiction for money. I'm not surprised they were charged for their conduct here, but I am surprised they participated in these acts because they are doctors. It is reprehensible.”

Johnson-Norris believes that the fact that doctors were involved is “the most significant thing about this case.”

“These doctors had a vulnerable patient who needed their help with his addiction. Instead, they took advantage of their position and kept him addicted to ketamine for profit. That is shocking and disturbing and definitely an aggravating circumstance in this case,” she says.

Although ketamine can be a safe and effective treatment for mental health problems when administered properly by a healthcare professional, this case should serve as a serious warning.

“We see that ketamine is everywhere and can be extremely dangerous outside of a medical context,” says Johnson-Norris. “The fact that it is promoted as a treatment for mental illness and addiction only exacerbates the problem through its potential for abuse. Websites and supposed online doctors and wellness centers that offer such drugs should be more closely scrutinized to protect the public.”