“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.

Amber cold health alerts have been announced for parts of northern England after forecasts warned that falling temperatures could lead to more deaths, particularly among older and vulnerable people. The UK Health Security Agency has issued two amber-level alerts for north-east and north-west England, which will be in effect from 8pm on Sunday until midday on Monday 5 January.

UK Under Amber Cold Health Alert: Elderly And Vulnerable People At Highest Risk

The agency said the expected cold spell is likely to increase pressure on healthcare services, with more vulnerable people needing medical attention. Officials warned this could lead to a rise in deaths, especially among those aged 65 and above and people with existing conditions such as heart disease, respiratory illnesses, and other long-term health problems.

UK Under Amber Cold Health Alert: UKHSA Gives Alert

UK Under Amber Cold Health Alert: Concerns Over Indoor Temperatures

The agency warned that indoor temperatures in buildings such as hospitals, care homes, and clinics are expected to drop. Maintaining the recommended indoor temperature of 18C may be difficult, increasing health risks for patients and residents. While all other regions in England will be under a lower-level yellow alert, officials said there is still potential for added pressure on health services. Staffing shortages linked to travel disruption were also flagged, along with possible impacts on essential services such as transport and energy.

How Does Cold Weather Affect People In The UK

Cold weather in the UK can worsen existing health problems and create new risks, particularly during prolonged spells of low temperatures. It places extra strain on the heart and lungs, increases the likelihood of infections, and can make daily life harder for people who struggle to keep warm. Those living in poorly insulated homes or facing high heating costs are often hit the hardest.

The Met Office said much of England will remain cloudy overnight, with patches of frost and fog likely to develop. These conditions could lead to difficult and potentially hazardous travel on Monday morning.

Sub-zero Temperatures Forecast In Parts Of The UK

Overnight temperatures are expected to fall to around minus 1C in Penrith and hover close to freezing in parts of the Lake District where the amber alert is in place. In northern areas of Scotland, temperatures are forecast to drop further, reaching between minus 6C and minus 7C, as per Sky News.

A brisk northerly breeze is also expected along the north-east coast of England, making conditions feel colder and more uncomfortable. Dr Agostinho Sousa, head of extreme events and health protection at UKHSA, as per Sky News, urged people to look out for friends, family, and neighbours as the cold weather sets in.

“The temperatures we are expecting can have a serious impact on health,” he said. “They increase the risk of heart attacks, strokes, and chest infections, particularly among people over 65 and those with existing health conditions.”

Nearly 200 residents of Piprauli village in Uttar Pradesh’s Budaun district received anti-rabies injections as a precaution after learning that the raita, a curd-based dish served at a funeral, had been prepared using milk from a buffalo that later died following a dog bite.

Rabies Scare In Uttar Pradesh: Nearly 200 Villagers Get Vaccinated

Almost 200 people from Piprauli village in Uttar Pradesh’s Budaun district were given rabies vaccines as a safety measure days after consuming raita made from the milk of a buffalo that had been bitten by a dog. Villagers said the funeral ceremony took place on December 23, where raita was served to attendees. It later came to light that the buffalo whose milk was used had been attacked by a dog a few days before the event, as per NDTV.

The buffalo died on December 26, which led to panic in the village amid fears of possible infection. Soon after, villagers visited the Ujhani Community Health Centre, where they were administered rabies vaccinations.

Rabies Scare In UP: CMO Dr Rameshwar Mishra Clarifies Risk Of Transmission

Chief Medical Officer Dr Rameshwar Mishra said on Sunday that authorities were informed about a buffalo in the village that had been bitten by a suspected rabid dog and later died after showing symptoms associated with rabies.

There were reports that villagers had consumed what was believed to be “infected” raita. As a precaution, everyone who may have been exposed was advised to get vaccinated.

“Prevention is better than cure. Anyone who had even the slightest doubt was given the anti-rabies shot. Usually, there is no risk after milk has been boiled, but vaccination was done to eliminate any possible danger,” Dr Mishra said, as per NDTV. The health department confirmed that no cases of illness have been reported in the village so far and that the situation remains stable.

The CMO added that all those who came for vaccination were given the injection without delay at the Ujhani Community Health Centre. To ensure smooth access, primary and community health centres remained open on both Saturday and Sunday.

What Is Rabies Pre-Exposure Prophylaxis Vaccine?

Rabies pre-exposure prophylaxis, also known as PrEP, involves a series of injections taken before any potential exposure to the rabies virus, as per Cleveland Clinic. It is mainly advised for people at higher risk, including veterinarians, animal handlers, laboratory staff, and travellers visiting areas where rabies is common. While PrEP does not eliminate the need for treatment after a bite, it simplifies post-exposure care. Those who have received PrEP require fewer follow-up doses and do not need rabies immunoglobulin, which can be difficult to obtain during emergencies and can save valuable time.

How Can Rabies Pre Exposure Prophylaxis Vaccine Protect You?

According to Dr Deepa Aggarwal, MD, DNB, an allergy specialist with over 20 years of experience from LHMC and AIIMS Delhi, who shared insights on her Instagram account, the rabies pre-exposure prophylaxis vaccine helps prepare the immune system in advance.

It allows the body to build antibodies before any exposure occurs. If a vaccinated person is bitten later, they only need two booster shots and no immunoglobulin. This faster immune response reduces the chance of the virus reaching the brain, which is especially important for people at higher risk or in situations where medical care may be delayed.

Today, Delhi again woke up to a thick layer of smog, and the adjoining cities like Noida, Ghaziabad, Gurugram, and Faridabad too woke up to zero-visibility fog on Monday. The air quality too dipped down to 'severe' category, with AQI registered at 400 plus on the index. While on Sunday, the AQI did show some improvement, as the city registered 'very poor' AQI, however, by the end of the day, the capital city was trapped under fog and pollution.

Delhi Struggling With Pollution And Cold Wave

The Indian Meteorological Department (IMD) has also issued an orange alert for Delhi on 29 December, Monday. The maximum temperature is expected to be around 22 degree Celsius, while the minimum will be at 7 degree Celsius. Mornings would encounter heavily dense fog, while there is an expectation of marginal relief on December 30. Most of North India is also said to be worst hit, including states like Uttar Pradesh, where thick fog is predicted till December 31, Punjab and Haryana is expected to face cold wave through December 30, and Himachal and Uttarakhand could see rain and snowfall from December 30 onwards.

As per IMD, cold wave is a condition of air temperature which becomes fatal to human body when exposed. This happens during the winter seasons and the cold wave impact gets aggravated due to wind speed. Cold Wave is considered when minimum temperature of a station drops to 10 degree Celsius or less for plains and 0 degree Celsius for Hilly regions.

Read: Delhi Sees Some Relief From Toxic Air; GRAP IV Removed, 'Will Bring Down Pollution In 5 Years,' Says Nitin Gadkari

How Can Cold Waves Impact Your Health?

IMD says that cold wave could cause mild to severe hypothermia. The common symptoms include shivering, dizziness, drowsiness, irritability, confusion, slowed, slurred speech, and altered vision. This happens when body experiences a lowered core temperature below 34.4 degree Celsius.

Frostbite is another health hazard that can happen due to cold waves. It is freezing of body tissue, accompanied with hypothermia. When ice crystal form between the cells of the skin and grow by extracting fluid from the cells, the circulation is obstructed, causing additional damage to the tissue affected. It commonly affects hands, feet, ears, nose and cheeks. The common symptoms are redness in skin, or skin turning grey. Some may also experience tingling sensations, fingers turning numb yellowish, waxy, or grey color.

Chilblains could be caused due to exposure to cold, wet, and humid conditions. Repeated prolonged exposure of bare skin could lead to this development in just few hours. It could impact your ears, nose, cheeks, fingers, and toes. Common symptoms include skin turning pale and colorless, prickly sensations, red, swollen, hot, and itchy skin and blisters.

Dehydration could also happen due to lack of fluid intakes, which is common during extreme cold. This could lead to headaches, dizziness, dry mouth, stomach cramps, and increased heartbeat. IMD notes carbon monoxide poisoning or CMP, snow blindness, and trench foot are also common during cold seasons, and provides ways to prevent these from happening.

What Do These Alerts Mean?

Delhi is currently under Orange Alert for cold wave. What do these different alerts mean?

Green Alert: This means no action will be taken, as this is a normal day during winter season

Yellow Alert: This means 'be updated' and refers to cold wave alert where the conditions in isolated areas may persist for two days

Orange Alert: This means 'be prepared' and refers to severe cold wave conditions that could persist for two days. This could also mean that though the condition is not severe, but the conditions could persist for four days or more

Red Alert: This means 'take action' and refers to severe cold wave conditions that persists for more than two days, or total number of cold wave days exceeding six days