Los Angeles, California - Friends star Matthew Perry died as a result of "the acute effects of ketamine," the Los Angeles County Medical Examiner's office said Friday.

Perry, who played Chandler Bing on the hit TV sitcom from 1994-2004, died at the age of 54, having struggled for decades with addiction and related serious health issues.

"Contributing factors in Mr. Perry's death include drowning, coronary artery disease and the effects of buprenorphine (used to treat opioid use disorder)," the medical examiner said in a statement.

"The manner of death is accident. "

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Perry was found unconscious in a hot tub at his house in Los Angeles on October 28. First responders were unable to revive him, and an initial post-mortem proved inconclusive, pending a toxicology report.

Doctors and veterinarians often employ ketamine as an anesthetic, and researchers explore it as a treatment for depression. Underground users take it illicitly for its hallucinogenic effects.

Friends, which followed the lives of six New Yorkers navigating adulthood, dating, and careers, drew a massive global following.

But even as he delivered on-air gag after gag — and earned a fortune — Perry was struggling.

He attended multiple rehabilitation clinics to combat his addiction to painkillers and alcohol. In 2018, he suffered a burst colon related to drug usage and underwent multiple surgeries.

In his memoir Friends, Lovers, and the Big Terrible Thing, published last year, Perry described going through detox dozens of times. He dedicated the book to "all of the sufferers out there" and wrote in the prologue: "I should be dead."

"I have mostly been sober since 2001," he wrote, "save for about sixty or seventy little mishaps over the years."

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But his sudden passing drew shocked reactions from Hollywood A-listers, his costars, and Friends fans worldwide.

"Oh boy this one has cut deep," said Jennifer Aniston, who played Rachel on the show.

"He was such a part of our DNA. We were always the 6 of us. This was a chosen family that forever changed the course of who we were and what our path was going to be," she wrote on Instagram.

"The times we had together are honestly among the favorite times of my life," wrote Matt LeBlanc, who played Perry's roommate and best friend on the show.