“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.

Being rich is usually linked with better chances at living longer as one may have access to the best healthcare services, healthier food, free time for exercise and wellness and more. But a large international study has found a striking exception. It observed that the wealthiest individuals in America had survival rates comparable to some of the poorest people in Northern and Western Europe.

The study, published in the New England Journal of Medicine, analysed data from 73,838 adults aged 50 to 85 in the US and 16 European countries, following participants from 2010 to 2022. Researchers compared people according to their relative wealth within their own countries.

The findings suggest that wealth improves survival in both regions, but Americans had higher mortality at every wealth level than their European counterparts.

About 80% Of Wealthiest Americans Survived

The researchers found that about 80% of the wealthiest Americans were still alive at the end of the study period. That was roughly comparable to the survival rate among the poorest participants in Northern and Western Europe. Among the wealthiest Northern and Western Europeans, the survival rate was approximately 90%.

Lead author Irene Papanicolas, professor at Brown University School of Public Health, said, “We were surprised by that result.”

She said researchers might expect wealthy Americans to have access to high-quality healthcare, healthier food and safer environments, yet the data showed that their survival still lagged behind wealthy Europeans as well as the poorer populations .

Why Do Americans Have Higher Mortality Rate Than Europeans?

Also read: Bryan Johnson Reveals Meibomian Gland Dysfunction: What To Know About This Dry Eye Condition

The study does not find any one specific reason for the significant difference. However, researchers point to several possible contributors, including economic inequality, healthcare access, social safety nets, diet, smoking, _{physical activity}, stress and environmental risks. Differences in social and economic conditions could also affect health even among healthier people.

Papanicolas said the findings highlight factors that can affect health across different wealth levels, including “economic inequality or risk factors like stress, diet or environmental hazards.”

Co-author Sara Machado, a research scientist at Brown’s Center for Health System Sustainability, said where someone stands within their country’s wealth distribution matters for longevity, but so does how that country compares with others. She also noted that improving health outcomes is “not just a challenge for the most vulnerable”, as even people in the highest wealth group can be affected.

The US-Europe Life Expectancy Gap Has Widened

The findings come against a broader backdrop of declining US life expectancy compared with other wealthy nations. Researchers noted that the US and Western Europe had broadly similar life expectancy several decades ago, but the gap began widening around 1980 and kept going until it is now hard to ignore.

The study therefore raises a bigger question about whether individual wealth alone can protect people from broader health risks within a society.

The observational study cannot prove that living in the US itself causes higher mortality. The researchers identified possible explanations, but further research is needed to determine exactly why mortality remains higher among Americans across wealth groups.

The Ebola outbreak in the Democratic Republic of Congo (DRC) has resulted in more than 300 deaths in a single week, marking one of the highest weekly death tolls since the outbreak began in mid-May.

According to the latest data by the DRC's Ministry of Health, 5,514 confirmed cases and 2,642 deaths had been recorded as of August 23. The outbreak, caused by the Bundibugyo virus, has already become the largest and the deadliest Ebola outbreak in history, surpassing the 2018-2020 epidemic.

Highest Weekly Death Toll

In terms of the pace of the Ebola outbreak, the latest numbers follow an alarming pattern. WHO previously reported 304 deaths and 579 cases in the week of August 3-9, the highest weekly totals recorded at that point.

An earlier WHO update had recorded 296 deaths in one week, showing how rapidly the outbreak has escalated over recent weeks.

The increase is partly linked to expanded surveillance and testing, but WHO says most of it is due to genuine expansion of the outbreak.

Rare Bundibugyo Strain Is Making Containment Challenging

Also read: DR Congo Gets 70,000 Ebola Vaccine Doses For A Different Strain: Can Ervebo Protect Against Bundibugyo?

Unlike the Zaire species of Ebola, for which licensed vaccines and treatments exist, this outbreak is being driven by Bundibugyo virus, a rare Ebola species that has not been studied adequately.

There is currently no approved vaccine specifically for Bundibugyo virus, making the response more challenging. However, DRC recently received 70,000 doses of the Ervebo vaccine, which targets Zaire strain. It is being evaluated for potential protection against Bundibugyo virus. WHO says early laboratory and animal studies suggest that the vaccine may provide some protection against Bundibugyo.

But in parts of eastern DRC, health workers face attacks, communities are displaced and people frequently move between areas. These factors allow transmission chains to continue undetected. WHO has warned that sustained transmission across communities that are interconnected is driving the aggressive expansion.

The outbreak has also been affected by misinformation and mistrust, which can discourage people from seeking treatment or cooperating with response teams.

Health Workers And Remote Communities At Major Risk

Also read: Congo's Ebola Outbreak Is Spreading Fast But WHO Says It Can Still Be Contained In 3 Months

The outbreak has spread across dozens of health zones, with Ituri remaining the epicentre. WHO reported that cases had reached at least 54 health zones across six provinces by August 12.

Health workers have also been heavily affected. At least 155 healthcare workers had contracted the virus and 45 had died as of August 9, according to WHO.

Insecurity, population displacement and poor access to healthcare are making it harder to identify cases, trace contacts and get infected people into treatment quickly.

WHO Says The Outbreak Can Still Be Contained

Despite the alarming numbers, WHO officials have said the outbreak can still be brought under control if response efforts are scaled up as soon as possible.

WHO Director-General Tedros Adhanom Ghebreyesus and Africa CDC Director-General Jean Kaseya have stressed the importance of surveillance, increasing treatment capacity and working closely with affected communities to tackle the outbreak.

NHS England has announced the rollout of free home HPV testing kits, which could make cervical screening more accessible to nearly 4 million women who are not currently up to date with their screening.

The move is being described as a “game-changer”, as around a third of eligible women are not up to date with their cervical screening. The kits aim to provide a more “discreet and convenient option” for women who may not have attended screening previously.

“Offering millions of women an alternative test they can do from the comfort of their own homes will be a game-changer – making it easier than ever for them to get tested for HPV,” said Dr Sue Mann, National Clinical Director for Women’s Health at NHS England.

Importantly, the NHS stated that the home HPV testing is "not a replacement for cervical screening". Cervical screening appointments with a clinician remains the best way to help prevent cervical cancer.

The NHS is introducing HPV self-testing as an additional option for people who have not taken up previous invitations.

The initiative is also part of the NHS pledge to eliminate cervical cancer by 2040, by making it as easy as possible for people to get lifesaving HPV vaccination and increasing cervical screening attendance.

What Does The HPV Self-Testing Kit Contain?

The self-testing kit contains a swab, similar to a long cotton bud, which is used to collect a sample from the vagina. The sample is then posted back to the NHS for free, where it is checked for high-risk HPV.

If high-risk HPV is found, individuals will be invited to book a follow-up cervical screening appointment at their GP surgery or sexual health clinic. A nurse or doctor will then take a small sample from the cervix to check for cell changes.

Who Can Get The Free Home HPV Test?

HPV self-testing is an invitation-only offer and is being rolled out in phases across England as part of the NHS Cervical Screening Programme.

The rollout starts with people aged 30 to 65 who have not attended cervical screening following previous invitations.

Women aged 24 to 64 are invited for cervical screening by the NHS every five years, or more frequently if HPV is detected.

Women who are eligible will start receiving invitations via the NHS App, text message, email or letter. Once invited, they will be able to order a free kit through the NHS App or their NHS online account.

“There are lots of reasons that may stop women from getting their cervical screening – embarrassment, lack of time, or worries about discomfort – and these kits provide a discreet and convenient option we hope will encourage more women to take up the life-saving test. So, if you’re invited to take part, please order a test – it’s a simple swab you can do at home in minutes,” she added.

Is Cervical Screening Important Even After HPV Vaccine?

Cervical screening helps prevent cervical cancer by checking for high-risk types of HPV. HPV is a common virus that can cause changes to cells in the cervix. These changes can usually be treated before cancer develops.

The NHS noted that it is still important to attend cervical screening appointments even if you have been vaccinated against HPV.

The HPV vaccine does not protect from all types of HPV, so there is still a small chance of developing cervical cancer.

People who routinely attend cervical screening with a clinician at their GP practice or sexual health clinic should continue to book their appointments as normal.

Anyone who has been invited for cervical screening can still book an appointment at any time, even if the invitation was sent months or years ago.