This is Why Matthew Perry Was Near Death and How You Can Stay Safe

Matthew Perry is revealing how he feels lucky to be alive after a long journey of battling addiction and life-threatening health issues that happened as a result of abusing drugs and alcohol for years. The 53-year-old is very forthcoming in his new memoir Friends, Lovers, and the Big Terrible Thing that will be released November 1st about his decades long struggle with getting sober. 

He wrote on Twitter back in February, "So much has been written about me in the past. I thought it was time people heard from me. The highs were high, the lows were low. But I have lived to tell the tale, even though at times it looked like I wouldn't. And it's all in here. I apologize it's not a pop up book." Us Weekly reports Perry's troubles started in 1997 after a jet ski accident. He became addicted to Vicodin, which he admits he took 55 a day and was down to 128 pounds. He told PEOPLE, "I didn't know how to stop..If the police came over to my house and said, 'If you drink tonight, we're going to take you to jail,' I'd start packing. I couldn't stop because the disease and the addiction is progressive. So it gets worse and worse as you grow older."

After many stints in rehab, the Friends star shared he almost died at age 49 when his colon burst from opioid overuse. He explained to PEOPLE he spent two weeks in a coma and five months in the hospital. In addition, he had to use a colostomy bag for nine months. "The doctors told my family that I had a 2 percent chance to live..I was put on a thing called an ECMO machine, which does all the breathing for your heart and your lungs. And that's called a Hail Mary. No one survives that."

So what helped stop him from taking drugs? "My therapist said, 'The next time you think about taking Oxycontin, just think about having a colostomy bag for the rest of your life,'" Perry recalls. "And a little window opened and I crawled through it and I no longer want Oxycontin anymore." Perry is now sharing his story in hopes of helping others and Eat This, Not That! Health spoke with addiction specialists and medical experts, who have not treated the star, but share their knowledge and insight on the disease. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Giovanni Bonomo, MD Director, Colorectal Surgery at Staten Island University Hospital explains, "When a patient's colon "bursts" or perforates, bacteria from the colon will escape into the peritoneal cavity which is a sterile environment.  There are times where the body can contain a perforation however in a non contained perforation, it can lead to an overwhelming infection, sepsis and even death if not treated emergently with surgery."

Tracey Childs, MD, board certified in general and colorectal surgery and chief of surgery at Providence Saint John's Health Center in Santa Monica, CA tells us, "The risk is about 4/100,000 people. The risk factors, with colon perforation being an extremely rare outcome,  include diverticulitis, obstruction from inflammatory or malignant causes, foreign body  or trauma including during colonoscopy which is less than in 2% of all colonoscopies.  In this particular situation, the perforation was likely related to severe constipation associated with the chronic narcotic use.  With severe constipation for all reasons, one can get a blockage from hard stool which then erodes through the colon wall causing an ulcerative perforation resulting in peritonitis or overwhelming infection of the abdominal cavity.

The risks after colon perforation are infection, abscess (pus collection), peritonitis (diffuse infection in the abdominal cavity) and likely in this case, overwhelming sepsis which is a systemic infection resulting in heart, lung, kidney and neurologic dysfunction resulting in the reported need for ECMO (life support), prolonged hospital stay and multiple surgeries."

Perry revealed he's had 14 surgeries on his stomach and told PEOPLE, "That's a lot of reminders to stay sober. All I have to do is look down. He has shared, "There were five people put on an ECMO machine that night and the other four died and I survived. So the big question is why? Why was I the one? There has to be some kind of reason."

Dr. Bonomo says, "Colonic perforation will often be accompanied by severe diffuse abdominal pain, fevers, chills, nausea, vomiting as well as changes in vital signs, lab work and imaging.  If anyone is experiencing these symptoms, they should go to the closest emergency department for evaluation."  Dr. Childs adds, "Colonic perforation is most commonly heralded by severe abdominal pain and sometimes associated fever, nausea and vomiting and loss of appetite. But, mostly PAIN!"

According to Dr. Bonomo, "Yes, the colon can be repaired after perforation.  Whether this is accomplished in one or multiple surgeries depends on the reason for perforation and the overall health of the patient. If it is not safe to repair the colon in the first surgery, the patient will often be given an ostomy, either an ileostomy or colostomy, to control the source of infection and allow them to heal.  Once they have healed, they will undergo another surgery to close the ostomy usually a few months later."

Dr. Childs adds, "Depending on the degree of contamination in the abdominal cavity and the stability of the patient involved, conservative options include antibiotics only or simply radiographic guided drainage of the abscess (contaminated fluid collection) to minimally invasive or open surgeries including simply washing out the contamination and draining the abdomen if the involved perforated segment cannot be identified v minimally invasive or open removal of the perforated segment with either restoration of continuity (i.e. putting the bowel back together again) at that time without or sometimes with a temporary protective diverting stoma (usually a diverting ileostomy) or as in this situation, removing the perforated segment and bringing up a colostomy likely because the situation was so dire that this was the most expeditious and safest procedure which would get him out of the operating room most quickly.

A colostomy can be reversed in many cases depending on the age and health of the patient and most times the reversal surgery is done 9-12 months after the colostomy is made.  But, statistics show that almost 40% of patients with what was intended to be a temporary colostomy never have it reversed."

Dr. Bonomo says, "Having a stoma comes with an adjustment period, however, most patients will become adept at caring for it within a few weeks.  These patients can still lead a healthy active life.  Once the stoma has been closed, depending on the circumstances, most patients will not have significant changes in their bowel habits. Our colon is redundant so removing a piece does not always lead to significant changes in bowel habits."

Dr. Childs says, "Having a colostomy is definitely an adjustment and one's quality of life is not only dependent on the quality of the stoma (i.e. is it easy to pouch, are the supplies readily available, is the output manageable) and the patient's attitude toward the colostomy (i.e. acceptance and move on "I'd rather be dead than have a colostomy").  People with stomas live regular lives, work, dance, camp, travel, have sex, deliver babies, exercise, swim and yes, even wear bathing suits).  If the colostomy is easily manageable, most of the time only the patient knows it's there, but those around are unaware.  I have so many stories about patients being sure they were the only one and finding out that their boss, or neighbor, or in law, whom they never suspected, also had a stoma.  There are also so many resources for people with stomas so they can learn and don't have to feel "alone" or ostracized."

Ricardo Whyte, MD Addiction Psychiatrist Section Chief of Psychiatry with Dignity Health St. Bernardine Medical Center  and Killing Burnout explains, "Two core components involved in defining addiction clarify that an addiction is something that a person does compulsively and that has negative consequences. This definition does not incorporate the concepts of tolerance or withdrawal but nevertheless helps us to understand when we are dealing with an addiction. People should also know that addictions are very common. Addiction is a disease. It is important to understand that there are neurobiological processes that affect and at times even drive our behavior and thereby can be the basis for addictive behavior. Addiction does not affect everyone the same."6254a4d1642c605c54bf1cab17d50f1e

Timothy Sullivan MD Chair, department of Psychiatry and Behavioral Sciences at Staten Island University Hospital says, "It is commonly said in Alcoholics Anonymous the people have to "hit bottom" before they change their drinking behavior. Persons with an alcohol use disorder will also acknowledge that "hitting bottom" means different things to different people. It can mean losing a job, losing a marriage, experiencing a serious health consequence, or losing everything. There are many general theories about behavior change – what must occur to alter a long-standing pattern, or what can predict or influence someone who's contemplating change. Motivational approaches, which are a mainstay of substance use disorder treatment, attempt to influence change behavior by helping individuals to identify personal and meaningful goals."

John Tsilimparis, MFT Psychotherapist, Mental Health Consultant, Author says, "Drug addiction is a disease of the brain that systemically affects many aspects of human functioning. Drug addiction often leads to an inability to control the use and causes major problems in both occupational and social functioning. In a sense, addiction is any kind of behavior or in this case, a dependence on a substance that has short-term benefits with long-term destruction. Addiction to alcohol or other mood-altering substances can start with experimental use of a recreational drug in social situations or after it is prescribed for physical pain after an accident or after surgery. Addiction and drug dependence is also tied to mental illness, where the user discovers the drug's benefits as a way to self-medicate the underlying mental health condition. But, sometimes individuals just use drugs to help cope with life's ups and downs.

However, as time passes, individuals may start to develop a tolerance for the drug and will require higher doses to get the same effect. They may also develop a chronic dependency on the drug which can also progress into experiencing withdrawal symptoms if they stop using the drug. Drug addiction is also negatively compounded by the social stigma that's attached to it. As a society, we still look down at individuals suffering from addiction. We often see their suffering as a weakness or a moral failing they have brought upon themselves."

Dr. Sullivan explains, "Substances like alcohol or prescription opioids are subject to the risk of misuse because of how they affect our brain reward pathways. While alcohol in moderation can for most people be a pleasant experience not associated with health risks, and prescription opioids like oxycontin can be very effective in providing pain relief for individuals with serious medical disorders, their potent effect on the mechanisms through which our minds experience pleasure led to compulsive patterns of behavior in vulnerable individuals. In the case of drugs like oxycontin that includes almost everyone except for those people who experience intense nausea when taking opiate-containing medication. The specific reasons why oxycontin became a national epidemic have entirely to do with the unscrupulous behavior of Purdue Pharma executives who sought to exploit the medication's properties for their own financial gain."

Joseph S. Haraszti, MD, Board Certified Psychiatrist, Board Certified in Addiction Medicine, Assistant Clinical Professor of Psychiatry USC KECK School of Medicine says, "Opioid addiction is one of the most dangerous forms of addiction, as more and more potent forms of the drugs have become easily available.  Fentanyl addiction has become an epidemic affecting people from all walks of life, including many teenagers.  Prince and Tom Petty both died of Fentanyl overdose. Vicodin or hydrocodone is an oral analgesic, which is an effective pain reliever for acute and chronic pain. Unfortunately, it is also very addictive.  For acute pain as Matthew Perry must have suffered following his jet ski accident in 1997, it is an appropriate analgesic.  However, it should only be prescribed for a short period of time.  Despite its addictive potential, it has a place in our therapeutic armamentarium.  We should be especially careful in prescribing it to someone who already has another form of addiction  e.g. alcoholism."

Dr. Whyte states, "Opioids are modern medicine's solution to pain. They are chemicals that interact with opioid receptors in the body and brain, resulting in a reduction in the perception of pain. Used according to prescription directions, they are extremely effective at managing short term pain after accidents, surgeries, and bodily traumas. The problem becomes when those that started off using opioids for pain management become dependent on the drugs. For those that are predisposed to addiction, opioid use is not as simple as sticking to the prescription directions. The CDC estimates that as many as 1 in 4 patients receiving long-term opioid therapy struggles with opioid addiction. 

Opiates are prescribed due to their potency in effectively addressing acute pain. Opiates even formed the basis of certain analgesics used in anesthesia allowing for surgical operations and procedures to take place. When used correctly opiates are an incredibly important tool in the arsenal of helping physicians carry out medical and surgical procedures and helping patients with a host of pain syndromes. There are even pain syndromes associated with certain cancers and other chronic conditions for which opiates play an important role. The problematic prescribing of opiates occurs when opiates are prescribed indiscriminately, and when risk assessments for abuse potential are not carried out carefully. Problematic prescribing can also occur when the medication utilization is not monitored carefully to assess for the drug being used in doses for which it was not prescribed or being used in ways for which it was not prescribed."

Dr. Haraszti says, "Given all the opioid deaths that have swept this country, there has been legislation and popular opinion against the use of all opiates, and against the doctors that prescribed them. We should keep in mind that in the early 2000's there was a movement and a big push by the big pharmaceutical companies that manufacture opiates, such as oxycontin and others, to legitimize these drugs.  Congress at one point passed a law that no American should suffer from pain and that pain should become the "fifth vital sign." Doctors across the country were required to attend 12 continuing education hours about pain management, which was a thinly veiled attempt to coerce doctors to prescribe these drugs. 

Two decades later, now that we saw the advent of "pill mills" primarily throughout Appalachia and Florida, there is a cynical overreaction to punish all doctors who prescribe opiates for legitimate indications. Matthew Perry's case highlights the easy availability of large quantities of daily doses of Vicodin at the height of his addiction.  Yes, his treating physicians should have been more aware, and we don't know what kind of interventions he may have had that resulted in his 15 rehab admissions.  In any event, this is today a huge public problem.  We should not throw the baby out with the bathwater.  We should establish guidelines for the appropriate use of opiates, and for proper monitoring and safeguards for patients who suffer from acute and chronic pain."

Experts say that gratitude is important in sobriety, which is something Perry openly expresses throughout his journey. "Everything starts with sobriety. Because if you don't have sobriety, you're going to lose everything that you put in front of it, so my sobriety is right up there," he tells PEOPLE. "I'm an extremely grateful guy. I'm grateful to be alive, that's for sure. And that gives me the possibility to do anything."

According to Dr. Tsilimparis, "There is strong research and science-based benefits that account for the powerful impact that practicing gratitude on a daily basis can have on people in the process of addiction recovery. Gratitude and sobriety are inseparable. Gratitude helps reduce fear, anxiety, depression, unresolved resentments, and the general self-absorption that the mind gets engaged in when stuck in a cycle of addiction. Practicing gratitude daily can improve people's moods. It's proven to promote joy and happiness and decrease feelings of isolation and loneliness. Gratitude helps individuals step outside themselves and appreciate everything they have today, instead of regretting the past and what they don't have anymore. It also helps to cultivate self-love in hopes of replacing self-loathing."

Dr. Whyte states, "Gratitude provides the lens with which we interact with our lives. When we look through the lens of gratitude at our past challenges or traumas, it allows us to take the good from an unfortunate situation and apply it to our lives going forward. In the context of addiction, gratitude often presents once someone has gone through their lowest of lows. Many times, only after battling through that lowest point does an addict value the opportunity they have to continue living, and with that gratitude, they decide to live a better life going forward. When we use gratitude to understand our past, it creates a clearer picture of our purpose for the future."

Dr. Tsilimparis says, "Anyone that has suffered years of dependence on poly-substances like opioid drugs and gone through multiple hospitalizations and treatment periods like Matthew Perry did, is lucky to be alive. Especially in recent years due to the increase in prescription drug overdose deaths since the onset of the pandemic in March, 2020. According to the CDC, in 2020 alone, over 90,000 people died from prescription drug overdoses in the United States. And provisional data from the CDC also indicates that there were an estimated 100,306 drug overdose deaths in the United States during the 12-month period ending in April of 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.

I admire Mr. Perry's strength and courage in sharing his illness and his recovery with us. I am sure his new book will help many out there that are still struggling with addiction and who are perhaps afraid to come forward. His honesty and humility remind us that drug addiction can affect anyone. It does not discriminate. We are all vulnerable."

Dr. Haraszti emphasizes, "Let's not forget that the 2 weeks in a coma and the 5 months of his hospital stay were complications of his opioid use.  However, most people don't have such a severe GI complication, simply as a result of the chronic and severe constipation that opioids cause.  There are ways that one can manage chronic constipation that should not result in such a drastic result.  However, for MP, this was the wake up call that motivated him to stop the downward spiral.  He decided that he wanted to live and that he wanted to have a better quality of life.  We don't know what dark demons he must have faced that propelled him toward alcohol addiction and later toward opioid addiction.  Yes, his survival is nothing short of miraculous.  However, many people hit rock bottom in different ways, if they don't die of their illness first."  

Dr. Whyte says, "I don't know about Matthew Perry's situation specifically, but almost 1 million people have died since 1999 (when opioids became a popular treatment option) from opioid overdose, with nearly 92,000 deaths occurring in the US in 2020. Long term opioid use can include risk of fractures, breathing problems during sleep, immunosuppression, bowel obstruction, and heart attack, to name just some of the risks. This is to say that given the many risk factors associated with chronic opioid abuse, it is a huge feat for anyone to come out unscathed after years of struggling with opioid addiction."