“I'm not great at the advice. Can I interest you in a sarcastic comment?”

This is what ‘Friends’ actor Matthew Perry’s character Chandler Bing was known for. He was known for being funny. However, he had his own struggles in his personal life and those struggles were acute depression. He was treating it with ketamine infusion therapy which is legal in the US and the UK.

What is Ketamine infusion therapy?

Ketamine is an anaesthetic used to treat depression, anxiety and pain under supervised and controlled medical settings. However, it does have its side effects, which can lead to distortion of sight, sound and time. It can also produce calming and relaxing effects.

Ketamine increases a person’s heart rate and blood pressure. If overdosed, it can leave users confused and agitated and can cause them to hurt themselves without even realising it. It can also lead to liver damage and bladder problems.

However, when used in moderation and under the supervision of medical doctors, it can treat depression where traditional antidepressants have failed.

Prof Rupert McShane, a University of Oxford psychiatrist who runs an NHS ketamine treatment clinic told BBC that ketamine “probably turns off the area of the brain that is involved in disappointment.”

Can Ketamine Infusion Therapy Kill Someone?

In simple terms, it cannot, be if the dosage is given in a controlled setting and as prescribed. Ketamine infusion therapy uses drugs in small doses than those used for anaesthesia. It acts faster than traditional anti-depressants, but the effects also wear off way quickly. Which is why it is important to monitor patients’ mental state for relapsing back into depression and discouraging them from overdosing on it.

There are ways of giving people ketamine. One of the ways is through “infusing”, which means to use an IV drip. However, injections, nasal sprays and capsules are also methods used to give people ketamine.

Since the dosage of ketamine used in the infusion treatment is small, it being the reason of actor Perry’s death was ruled out. The medical examiner also noted that Perry’s last ketamine infusion therapy session happened more than a week before his death, which means by the time he had died, it must have worn off.

So, What Happened To Perry?

Though Perry’s last session was more than a week before, his post-mortem showed that his blood contained a high concentration of ketamine. He had died of the “acute effects” of ketamine.

If it was not his session, then how did he get ketamine?

Prosecutors alleged that his assistant gave him at least 27 shots of ketamine in four days before his death, reported BBC.

Perry has been open about his personal struggles and this is what the doctors and dealers used against him. Martin Estrada, the US attorney for California’s Central District told the BBC that people took advantage of his condition. They charged him 165 times more than what vials of ketamine cost.

Names that have come up include Dr Salvador Plasencia, drug dealers “Ketamine Queen” aka Jasveen Sangha and Eric Fleming, and Perry’s live-in assistant Kenneth Iwamasa.

Who Are These Names And What Did They Do?

Ketamine Queen or Sangha supplied drugs that led to Perry’s death. Her home was a “drug-selling emporium,” said Estrada. More than 80 vials of ketamine, and thousands of pills including methamphetamine, cocaine and Xanax were allegedly found in her house known as the “Sangha Stash House.”

Sangha is known to deal with high-end celebs and was a “major source of supply for ketamine to others as well as Perry,” said Estrada.

Dr Plasencia called Perry a “moron” while charging him $2,000 for vials that cost only $12. He sold Perry 20 vials of ketamine between September and October 2023, costing $55,000.

He was the one who taught Iwamasa, who had no medical knowledge to inject the drug. This is after he knew that “Perry’s ketamine addiction was spiralling out of control,” as per what the investigators told the BBC.

Another dealer Fleming was told by Sangha to “delete all our messages.” While Fleming pleaded guilty to conspiring to distribute drugs unlawfully, he also allegedly messaged Sangha: “Please call...Got more info and want to bounce ideas off you. I’m 90% sure everyone is protected. I never dealt with [Perry] only his assistant. So the assistant was the enabler.”

The court documents also revealed that he asked Sangha on whether the ketamine stays in your system or “is it immediately flushed out.”

Dr Pepper, Bots, Cans

The people who allegedly exploited Perry used coded language for ketamine and called it “Dr Pepper”, “bots”, or “cans.”

Selling overpriced drugs, taking advantage of Perry’s mental condition and falsifying medical records to make the drugs given to him look legitimate by Dr Plasencia is what took Perry’s life.

Iwamasa is said to have administered more than 20 shots of ketamine and three on the day Perry died. Whereas ketamine is only administered by a physician. Authorities also found that weeks before Perry’s death, Dr Plasencia allegedly bought 10 vials of ketamine and intended to sell to Perry.

He also injected Perry with a large dose, two days later. This caused him to “freeze up” and spiked his blood pressure.

When I Die, I Want Helping Others To Be The First Thing That’s Mentioned

Perry had always been open about his drug addictions, struggles with alcohol and his depression. He said that his openness would help others who are also struggling and wanted to be remembered by his quote which also is on the homepage of the Mattew Perry Foundation that helps others struggling with the disease of addiction: “When I die, I want helping others to be the first thing that’s mentioned.”

Five arrests have been made in the case so far.

Cancer is a dreaded diagnosis. Along with the physical and emotional toll, patients and their families face the financial burden of treatment, as cancer medicines can be extremely expensive. In a major relief for patients, India has approved a cap on the trade margins charged in the supply and sale of non-scheduled anti-cancer medicines.

According to the Department of Pharmaceuticals under the Ministry of Chemicals and Fertilizers, these margins will be capped at 30% of the Maximum Retail Price (MRP).

“The measure is expected to reduce medicine prices by up to 70% and help cancer patients save Rs 2,500 crore annually, significantly reducing the amount they pay from their own pockets,” the Ministry said in a statement.

Essential cancer medicines included in the scheduled list are already subject to government-mandated ceiling prices. The new decision extends price protection to non-scheduled cancer medicines, which fall outside that list, by limiting the trade margins added as medicines move through the supply chain.

Rising Cancer Burden And Drug Costs

Also read: Indian Medical Industry Backs Maharashtra FDA Crackdown On Device Markups

Cancer treatment places a substantial financial burden on patients and their families, who often have to pay significant amounts out of pocket. In India, approximately 60 people per lakh population are affected by cancer.

According to a National Pharmaceutical Pricing Authority (NPPA) analysis of market data, non-scheduled anti-cancer medicines carry an average price markup of approximately 170%, reaching 700% or more in some cases.

Prices can rise sharply as a medicine moves through the supply chain before reaching the patient. They also vary significantly depending on whether medicines are purchased from retail pharmacies, hospital pharmacies or online pharmacies.

The new cap aims to curb excessive trade margins, address unfair pricing practices and help ensure fairer prices for patients, particularly those who require expensive cancer medicines.

Supreme Court Flags Steep Markups On Cancer Drugs

Read More: Antibiotic Costing ₹86 Carries MRP Of ₹4,528: Karnataka FDA Flags Massive Drug Price Gaps

State authorities, including those in Maharashtra, Rajasthan and Karnataka, along with patients and civil society groups, have raised concerns about excessive medicine prices.

Recently, the Supreme Court also questioned the Centre over the steep prices of life-saving medicines, particularly cancer drugs.

The Court pointed to the absence of adequate price-control mechanisms and sought to know why certain medicines remain outside the scope of the Drugs (Prices Control) Order (DPCO).

During the hearing, Justice Sandeep Mehta highlighted the significant markups on cancer medicines, citing an example in which a drug supplied to retailers for approximately Rs 3,000 was being sold at an MRP of Rs 27,000.

“27,000 MRP of a cancer drug, price to retailer is around 3000. Just see the drastic difference,” Justice Mehta stated.

The Bench also questioned the government over the absence of a uniform criterion of 16%.

The Court had previously flagged a similar instance involving a cancer medicine priced at Rs 2,700 but sold for Rs 27,000, raising concerns about the financial burden on patients who require life-saving treatment.

In February 2019, at the government's direction, the NPPA capped trade margins on 42 selected non-scheduled anti-cancer medicines under Paragraph 19 of the Drugs (Prices Control) Order, 2013.

The decision reduced MRPs by up to 91%, with reported annual savings of ₹984 crore across 526 brands. It significantly eased the financial burden on cancer patients.

Which Cancer Drugs Will Be Covered?

The intervention will cover non-scheduled anti-cancer medicines across categories, including branded and generic, domestically produced and imported, and patented and non-patented drugs.

An expert committee under the Directorate General of Health Services (DGHS) will finalise the list of medicines to be covered. The NPPA will then take a decision and issue the notification.

The Ministry said manufacturers of non-scheduled anti-cancer medicines will be required to maintain their current production levels to ensure that these life-saving drugs remain available.

Shigellosis, an intestinal infection caused by Shigella bacteria, is becoming harder to treat as drug-resistant strains spread in the US and UK.

Although the infection can spread through contaminated food and water, sexually transmitted Shigella has become an established part of transmission in some communities, particularly among gay, bisexual and other men who have sex with men (GBMSM).

An estimated 450,000 people acquire shigellosis each year in the US. While the infection can affect anyone, some strains have developed resistance to multiple antibiotics, making treatment increasingly challenging.

Drug-Resistant Shigella Rising In The US

A CDC analysis published in April 2026 found that extensively drug-resistant (XDR) Shigella isolates increased in the US between 2011 and 2023. Among 16,788 isolates analyzed, the proportion classified as XDR rose from 0% in 2011–2015 to 8.5% in 2023.

The CDC report found that 86.2% of XDR shigellosis patients with available sex data were men. However, sexual exposure information was not routinely collected, so the findings do not establish that these infections were sexually transmitted.

Molecular biologist Shangxin Yang said healthcare workers at the University of California, Los Angeles (UCLA), are now seeing roughly one case of extensively drug-resistant Shigella a month, compared with just one case throughout 2022.

"It's almost like an explosion of this pathogen in the community," Yang told CIDRAP News at the University of Minnesota.

The CDC has warned that XDR Shigella infections pose a treatment challenge because these strains are resistant to multiple antibiotics, and no FDA-approved oral antimicrobial treatment is available for them.

Sexually Transmitted Shigella Spreading Faster In The UK

A July study published in The Lancet Infectious Diseases found that sexually transmitted Shigella strains are spreading faster than non-sexually transmitted strains in the UK and developing resistance to key antibiotics.

Over an evolutionary period of about 2.5 years, sexually transmitted strains spread an average of 117 kilometers between related cases, compared with 46 kilometers for non-sexually transmitted strains.

“Many men who have sex with men are unaware of the serious and increasing risk posed by sexually transmitted Shigella,” said Professor Kate Baker, senior author of the study from the University of Cambridge's Department of Genetics.

Baker said sexually transmitted shigellosis should be treated as a distinct public health threat requiring different surveillance, prevention and treatment strategies.

Why Is Sexually Transmitted Shigella Becoming Drug-Resistant?

Cambridge researchers found that antibiotic-resistant sexually transmitted Shigella strains were spreading 71% faster than drug-susceptible strains. More than 70% of sexually transmitted strains were resistant to at least one clinically important antibiotic.

“This isn’t just one form of sexually transmissible diarrhea. This is multiple overlapping variants emerging that are all quickly becoming resistant to the drugs we use to treat them,” Baker said.

They believe the rise in resistance may partly be driven by antibiotics prescribed to treat or prevent other sexually transmitted infections (STIs), including gonorrhea.

“Our evidence suggests that the variants of Shigella transmitting in sexual networks were actually getting resistant against treatments for other STIs, like gonorrhoea, so people need to remember that when they’re taking antibiotics they’re treating their whole body,” Baker said.

Another possible factor is bystander resistance, in which antibiotic exposure affects bacteria other than the intended target and can favor the survival and spread of resistant bacteria.

How To Prevent Sexually Transmitted Shigella

Precautions to reduce the risk of sexually transmitted shigellosis include:

• Avoiding sexual activity during illness: Do not have sex while experiencing diarrhea or recovering from a recent diarrheal illness.
• Waiting before resuming sexual activity: Wait at least two weeks after fully recovering before having sex again.
• Telling your healthcare provider about possible exposure: Mention your sexual history if you seek care for diarrhea or related symptoms.
• Asking about testing: Seek advice on appropriate testing and sexual health screening if you may have been exposed.

People experiencing symptoms should seek medical advice. Because some Shigella strains are resistant to multiple antibiotics, treatment should be guided by a healthcare professional, who can determine the appropriate approach based on the infection and its resistance profile.

As the US measles outbreak nears 4,000 cases and five deaths amid concerns over vaccine hesitancy, the new CDC director Erica Schwartz says the MMR vaccine is “absolutely safe.”

The US has reported 3,887 confirmed measles cases in 2026, with 95% occurring among unvaccinated people or those with unknown vaccination status, according to CDC data as of October 1. The outbreak has also claimed five lives in Pennsylvania, all reportedly among unvaccinated people.

As of October 5, Pennsylvania has reported 1,004 measles cases, including 198 hospitalizations and five deaths. Lancaster County alone has recorded 391 cases. The outbreak is the worst recorded in the US since the major measles resurgence between 1989 and 1991.

This week, New York Governor Kathy Hochul declared a statewide disaster emergency after the state recorded 108 measles cases through October 3. Of these, 92 cases were reported since July 15 across 18 counties, particularly in under-immunized rural communities.

CDC Director Calls MMR Vaccine ‘Absolutely Safe’

“If there's one vaccine that parents should be talking to their health care providers about in terms of immunizing their children, the measles, mumps, rubella vaccine is absolutely safe, absolutely effective,” said Erica Schwartz, speaking at the WSJ’s Future of Health event.

“We want to make sure that we're constantly telling Americans that the MMR vaccine is safe.”

Measles is a highly infectious disease that can be prevented with vaccination. Two doses of the MMR vaccine are recommended for children, while some adults may also need additional doses depending on their vaccination history and risk.

Measles was considered eliminated in the US since 2000. However, the country could lose that status as cases continue to rise. The Pan American Health Organization is expected to decide in November whether the US has lost its elimination status.

The Trump administration and HHS Secretary Robert F. Kennedy Jr. have faced criticism over their anti-vaccine stance and policies amid the measles resurgence. More recently, President Donald Trump announced a proposal to separate the MMR vaccine into individual shots, which experts have warned could have consequences.

Meanwhile, Schwartz attributed the rise in measles infections across the US to declining herd immunity, saying, “the herd immunity within this country and other nations is lower than ever before.”

“And so because of that herd immunity, we really want it to be about 95%. I think we're hearing 87% in some communities, 98% in other communities. Because the herd immunity is lower, that's why we're seeing this resurgence of measles.”

Schwartz Says Vaccine Hesitancy Is A Global Issue

The recently appointed CDC director also noted that while the US is nearing 4,000 measles cases, there have been more than 45,000 cases of measles in Mexico and Guatemala. She attributed it to global rise in vaccine hesitancy.

“So it's not just a United States issue; it's an international issue. And I think the key critical issue is that there is vaccine hesitancy not just within the United States, but we're seeing that vaccine hesitancy throughout the world. Again, my premise is that all happened around COVID, where we were seeing folks who were just not trusting vaccines in general,” Schwartz said.

“We were finding that children were not getting vaccinated because they were not going to school during that time frame. So there's a number of reasons why we're seeing this increase in measles,” she said, adding that “people are conflating their concerns about all vaccines; all vaccines are bad.”

Schwartz also defended Health Secretary Robert F Kennedy Jr., and said he has always maintained that the MMR vaccine is safe and effective.

“I think what people get confused is that the secretary does represent the voices of a number of Americans who are asking the questions about certain vaccines. [...] And so there's this shared decision-making that the secretary is very focused on to say, why aren't we having conversations with parents, with people that may have some concerns about vaccines, rather than saying it's an all-or-nothing premise,” she said.