Senior deputy medical examiner Raffi Djabourian added that other contributing factors in his death were coronary artery disease and the effects of buprenorphine, which is used to treat opioid use disorder.
“Drowning contributes due to the likelihood of submersion into the pool as he lapsed into unconsciousness; coronary artery disease contributes due to exacerbation of ketamine-induced myocardial effects on the heart,” he said.
Perry had been receiving medically supervised ketamine treatments for depression and anxiety at the time of his death, though the report noted that his last prescribed ketamine treatment was a week and a half before his death.
At the height of his fame, Perry was battling with addiction to painkillers and alcohol and attended rehabilitation clinics on multiple occasions.
In 2016, he told BBC Radio 2 that he could not remember three years of filming during Friends, because of drink and drugs.
After attempts at treatment, he wrote in his memoir that he had been mostly sober since 2001 – “save for about 60 or 70 mishaps”.