The Los Angeles County Medical Examiner’s Office has released its report on the death of actor Matthew Perry today, revealing that the Friends star died of “acute effects of ketamine,” with drowning, coronary artery disease, and the effects of buprenorphine, a drug used to treat opioid use disorder, all listed as contributing factors. Perry’s death has been ruled accidental.

According to Variety, Perry was undergoing ketamine infusion therapy, reportedly for treatment of depression and anxiety. Per the Medical Examiner’s report, “At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular overstimulation and respiratory depression.”

Perry was open, for many years, about his struggles with drug use; it was, among other things, a major subject of discussion in his 2022 memoir Friends, Lovers, And The Big Terrible Thing. He died on October 29 of this year, after being found, unresponsive, in a pool, reportedly at his Los Angeles home.

Perry’s death has been greeted with widespread outpourings of sympathy and support, both for his work as an actor, and for his kind personality and efforts to help others struggling with addiction. In 2011, he spoke before Congress, urging them to fund drug courts, which present alternate forms of rehabilitation to people convicted of drug abuses; he also founded Perry House, an addiction recovery facility focused on helping people with alcoholism. He had previously been acknowledged by the White House for his work in helping people struggling with addiction, and described it in interviews as being more satisfying than accolades he’d received for his work as an actor or performer. Back in November, just a week after his death, the National Philanthropic Trust established a Matthew Perry Foundation, designed to help people struggling with drug use and addiction.