The sitcom Friends was a cultural phenomenon that produced waves of nostalgia in those of us who came of age in the late 90s and early 2000s. The decade it was on spanned the era of transition from landlines to cell phones and the advent of the internet as we know it. The characters were relatable and adored by so many.
The news of Matthew Perry’s death was a shock to many. As soon as the internet learned of his passing, there were speculations about the manner of death—did he relapse on drugs and alcohol? Matthew Perry had been open about his struggles with substance use disorders and had created a sober living home in his previous Malibu residence. He became an advocate for addiction treatment and made it his purpose to help others struggling with substance use disorders.
As a psychiatrist, when I heard of his passing, I felt great hope that the toxicology report would not indicate a return to use. Not because that would be uncharacteristic of the course of a chronic illness, which can be marked by a return to use over the course of years and decades, but because of my awareness of what society’s interpretations would be. I knew that a public person’s private struggles due to a chronic illness would be used to judge and further stigmatize those who struggle with addictions. Society’s perception and stigma related to substance use disorders lack the nuance and experience necessary to appropriately assess the course of this harrowing chronic illness. Illnesses such as substance use disorders and death by suicide are treated differently, as if there is an asterisk denoting judgment. If an individual had spent their life advocating for diabetes and eventually died due to complications of diabetes, the story would be quite different; their advocacy would be lauded, and their eventual death due to the illness would be met without judgment but with an appreciation of the seriousness of the illness. Individuals who die from the sequelae of addictions aren’t afforded that treatment; instead, often they are judged in death as they are in life.
This stigma and judgment are part of what an individual suffering from substance use disorders walks through daily, and if there is a return to use, it is as if all the work and effort they did to maintain sobriety is erased. It feels like this occurs in death as well. We, as a society and health practitioners, have a lot of work to do in our understanding and handling of these illnesses. Whether Matthew Perry died in relation to a return to use is not the story here. The story is his advocacy for substance use disorders, his vulnerability to publicly share his private struggles, and his quest to humanize this very human chronic illness. We must work to de-stigmatize these very common illnesses and applaud Mr. Perry for his work and advocacy in the field of substance use disorders. Thank you, Mr. Perry, for your work and advocacy in the field of substance use disorders.
Courtney Markham-Abedi is a psychiatrist in Lexington, Kentucky. She has written widely about physician suicide and other psychiatric topics for online publications and has appeared on several podcasts, work that led feedspot.com to name her one of the 1,000 best health care journalists and editors.
Her peer-reviewed work centers on the metabolic and neurologic effects of antipsychotic medications, including case reports on a probable association between ziprasidone and worsening hypertension, ziprasidone-induced catatonic symptoms, and hypertriglyceridemia tied to the direct effects of olanzapine rather than to weight gain.
She has also written a novel, Unlocking Lakin, set in a psychiatric hospital in her hometown. The manuscript won first place for full-length prose from West Virginia Writers, and she is currently seeking an agent to represent it.
