Managing acute stimulant intoxication in ambulatory settings: a protocol-driven case report.

Area of Science:

• Public Health
• Pharmacology
• Addiction Medicine

Background:

• Rising stimulant use and overdose (overamping) strains US healthcare systems.
• Ambulatory settings offer effective harm reduction for overamping, reducing emergency room utilization.
• Clinical guidance for ambulatory overamping management is currently lacking.

Purpose of the Study:

• Develop a patient-centered protocol for ambulatory care of stimulant overamping.
• Present two case studies illustrating the protocol's implementation and outcomes.

Main Methods:

• Protocol developed by substance use disorder clinicians and pharmacy experts.
• Incorporated evidence for acute stimulant intoxication management and clinical expertise.
• Reviewed by a pharmacist specializing in psychosis and stimulant use disorders.

Main Results:

• Protocol implemented for patients presenting with overamping signs.
• First-line treatment: behavioral interventions (environmental modification, de-escalation).
• Second-line treatment: pharmacotherapy (benzodiazepines, antipsychotics).
• Two cases successfully treated, demonstrating continued care and stimulant use management.

Conclusions:

• Protocol-driven ambulatory care offers patient-centered, compassionate management for overamping.
• Ensures patient follow-up and promotes ongoing treatment for stimulant use disorder.
• Potential to reduce healthcare system strain by preventing emergency room visits.