Special Considerations

Keep the following safety principles in mind when interacting with a patient experiencing acute methamphetamine intoxication or stimulant-induced psychosis.^1,20,28

• Maintain a safe distance.

  Moving too close may be perceived as threatening and can increase agitation.

• Reduce environmental stimulation whenever possible.

  Avoid bright lights, excessive noise, or unnecessary activity that may worsen anxiety or paranoia.

• Speak slowly using a calm, reassuring voice.

  Clear, simple communication may help reduce fear and confusion.

• Use slow, deliberate movements.

  Sudden movements may be misinterpreted as threatening.

• Keep your hands visible.

  Unexpected movements can increase suspicion or paranoia.

• Maintain calm verbal communication.

  A sudden change in behavior—including abrupt silence, increasing paranoia, withdrawal from conversation, or escalating agitation—may indicate worsening stimulant-induced psychosis or loss of reality testing. If the patient's behavior becomes unpredictable or presents a safety concern, discontinue treatment, ensure the safety of patients and staff, and seek appropriate assistance.^1,28

Patients exhibiting signs of acute methamphetamine intoxication—including severe hypertension, chest pain, hyperthermia, seizures, altered mental status, or violent behavior—should not receive elective dental treatment. Emergency medical services should be activated whenever clinically indicated, particularly when life-threatening medical or psychiatric symptoms are present.^1,28,41