“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.

At least 1,450 people have lost their lives after two powerful earthquakes struck Venezuela last week. According to a missing persons website, nearly 50,000 people are still unaccounted for.

As rescue efforts continue, experts are warning humanitarian teams about hidden medical risks that could complicate emergency care in the affected region.

In a post on X, Jerome Adams, Professor at Purdue University, highlighted a newly identified rare genetic disorder—the mtND4 variant—found in some people of Venezuelan maternal lineage.

According to Adams, the mitochondrial mutation may increase the risk of severe neurological complications or even death following general anesthesia.

“Urgent alert for humanitarian teams responding to Venezuela earthquakes: Two powerful quakes struck a region tied to a newly identified rare genetic disorder in people of Venezuelan maternal lineage. This mitochondrial mutation (mtND4 variant) can cause severe neurologic complications or death after routine general anesthesia - especially sevoflurane.”

Adams, who has been Former IN Health Commissioner and 20th US Surgeon General, said that adults and children of Venezuelan maternal ancestry have been affected by the genetic disorder and that most reported cases involved sevoflurane.\

Suggesting safer alternatives, he said: “Use ketamine or propofol (with caution/monitoring) instead of volatile anesthetics like sevoflurane.” He further advised: “Avoid volatiles when possible until more data. Response coordinators & medical teams - please share widely with anesthesiologists on the ground!”

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Anesthesiology Groups Issue Safety Advisory

Earlier this year, the American Society of Anesthesiologists (ASA) and the Society for Pediatric Anesthesia (SPA) issued a joint communication advising anesthesiologists to ask patients about possible maternal Venezuelan ancestry before administering anesthesia. The guidance stated that patients with direct maternal Venezuelan lineage should be considered at potential risk.

Why This Genetic Mutation Is A Concern

According to experts, the mtND4 variant found in some Venezuelan populations has been linked to severe reactions following routine general anesthesia. The first known cases were reported in the early 2000s. The mutation is believed to increase the risk of catastrophic neurological complications in affected individuals.

Around 40 cases have been documented worldwide, including six to eight cases in the United States. While most reported cases have involved children, the American Society of Anesthesiologists says the risk is not limited to pediatric patients and may also affect adults.

Dr. Luis Rodriguez, an anesthesiologist at Nicklaus Children's Hospital in Miami and a fellow of the Florida Society of Anesthesiologists, said the first known cases emerged in the early 2000s after several members of a Venezuelan physician's family died following exposure to inhaled anesthesia. The cases occurred on different continents and years apart, Fox13News reported.

For years, similar tragedies were considered isolated and unexplained. However, as medical societies in Chile, Venezuela, Spain, and the US began sharing data, a pattern emerged: the patients were previously healthy and shared Venezuelan maternal ancestry.

Read More: Over 1 Million Children Referred for Mental Health Care in England, Anxiety Most Common Reason

Other Health Risks After The Earthquakes

In addition to the anesthesia-related concern, experts have also warned about mental health challenges, hygiene issues, and the heightened risk of infectious disease outbreaks among survivors.

“Given Venezuela’s weakened public health infrastructure from past earthquakes in the region, I would worry about cholera, typhoid and other enteric bacteria, hepatitis A, measles, vector borne illnesses for those homeless and sleeping outdoors. But cholera would be my big worry,” Prof Peter Hotez, Texas Medical Center (TMC) Professor-Vaccine Scientist-Author wrote on X.

“Venezuela’s damaged infrastructure + displaced populations create perfect conditions for rapid spread. Cholera is also my top concern due to water contamination risks, but typhoid, Hep A, measles, and mosquito-borne diseases (dengue, malaria) are also major threats for those sleeping outdoors. Urgent need for oral cholera vaccine, WASH interventions, and measles catch-up campaigns,” added Aftab Khan, a Board Certified Internal Medicine Physician, on X.

Barbecues, parades, and extravagant fireworks displays mark the Fourth of July weekend in the US each year. However, weather experts have issued a warning that a heat dome could result in increased temperatures across several parts of the country. Rise in mercury teamed with the nature of festivities is expected to pave the way for several health risks.

What Is A Heat Dome?

Heat domes, a severe weather pattern, refer to the phenomenon when a strong high-pressure traps hot air over a particular region, acting like a huge lid. It causes temperatures to soar for a specific period of time.

This can lead to extremely high daytime temperatures, hotter nights, droughts, higher risks of forest fires, and heat-related illnesses.

Heat Dome Looms Over Fourth Of July

According to meteorologists, several parts of the United States could experience extreme heat conditions during the Fourth of July holiday. On Sunday, the National Weather Service said that the record-shattering heat would grip the eastern part of the country.

The heat dome is expected to send the temperatures soaring into triple digits. Parts of Iowa, Missouri, and Kansas are among the most affected. States like Ohio, parts of North Carolina, and Washington, D.C will also see hotter days ahead.

Biggest Heat-Related Risks During Fourth of July

Prolonged exposure to high temperatures, especially during outdoor celebrations, can increase health risks like dehydration, heat exhaustion, and even heatstroke.

Fireworks and Heat

An extravagant display of fireworks is one of the important traditions of the holiday. However, extreme heat significantly increases the risk of accidental fires and other dangers of fireworks.

Heat Exhaustion And Heatstroke

Several traditional Fourth of July activities entail spending long hours outdoors, often during the daytime. This could pose risks of heat exhaustion and heat stroke. Symptoms typically include excessive sweating, dizziness, headache, nausea, muscle cramps, and weakness.

Dehydration

Hot weather combined with strenuous outdoor activities can cause the body to lose significant amounts of fluids through sweat. This could increase the risk of dehydration. Additionally, Fourth of July celebrations may include consuming alcoholic beverages, which can further contribute to dehydration.

Sunburn

Sunburn is also one of the significant health risks. Spending hours outdoors can also increase the risk of sunburn and skin damage. Unprotected exposure to ultraviolet (UV) radiation can lead to painful burns and increase long-term health risks like skin cancer.

How To Celebrate Safely

Health experts recommend a few simple precautions to enjoy the Fourth of July holiday safely:

Staying hydrated: Drink plenty of water throughout the day to avoid dehydration. Limit alcohol and caffeinated beverages, which can contribute to fluid loss.

Do not skip sunscreen: Ensure to apply a broad-spectrum sunscreen with an SPF of at least 30 and reapply every two hours, especially after swimming or sweating and on days with continued sun exposure.

Plan activities according to the weather: Schedule outdoor activities during the morning or evening when temperatures are lower.

Take breaks to cool down: Take frequent breaks indoors or in shaded areas. If possible, spend time in air-conditioned spaces.

Dress appropriately: Wear lightweight, loose-fitting, and light-colored clothing that could keep you comfortable and cool throughout the day

More than one million children in England had active referrals to mental health services last year, with anxiety remaining the leading reason for seeking support, according to a new report.

The annual report by Children's Commissioner Rachel de Souza warns that England is facing a growing children's mental health crisis.

New data for 2024-25 shows that 1,048,965 children had an active referral to Children and Young People's Mental Health Services (CYPMHS) — nearly double the number recorded in 2018-19 and almost 10 per cent higher than the previous year.

"The report clearly demonstrates the sheer scale of distress young people are facing today," de Souza said.

What Did The Report Find?

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• Record demand: More than 1.04 million children had active referrals to Children and Young People's Mental Health Services (CYPMHS) in 2024-25, nearly double the number recorded in 2018-19 and almost 10 per cent higher than the previous year.

• Anxiety remains the top concern: Anxiety accounted for 16 per cent of all referrals, making it the most common reason children were referred. Referrals for suspected autism rose by nearly 50 per cent in a year (65,530 to 96,393), while referrals for other neurodevelopmental conditions increased 24 per cent.

• Growing treatment backlog: Despite more children receiving treatment, 35 per cent of referred children were still waiting for care by March 2025, up from 33 per cent the previous year and 29 per cent in 2022-23.

• Long waits for support: More than 60,000 children had been waiting for treatment for over two years, compared with 44,000 the previous year. Those still waiting had an average wait of 224 days.

• Poor access for autism support: Fewer than one in five children with suspected autism or neurodevelopmental conditions received treatment. For suspected autism alone, only 13 per cent accessed care by March 2025, with an average wait of about one year.

• Ethnic disparities: Black and Asian children were less likely to be referred but more likely to reach services only in crisis. One in four Black children were referred in crisis, compared with 16 per cent of Asian and 7.4 per cent of White children.

• Age differences: Adolescents aged 13-15 accounted for 35 per cent of children receiving treatment, while younger children were more likely to face longer waits or have referrals closed before treatment.

• Socioeconomic inequality: Children from the poorest 10 per cent of areas made up 15 per cent of referrals, compared with 7.6 per cent from the least deprived areas.

• Gender gap: Boys were slightly less likely than girls to be referred and to receive treatment after referral.

The Need to Improve Children's Mental Health

"These are not just numbers, but children whose lives have been put on hold for months and, in some cases, years waiting for support they urgently need," de Souza said.

She urged greater investment in children's mental health and called for stronger support across schools, healthcare and social care.

de Souza stressed the need for "greater focus on services across health, education and social care to ensure children are getting the help they need in schools and the community".