A 24-year-old man is brought to the psychiatric emergency department by police after being found standing in the middle of a busy intersection directing traffic while talking to unseen others. Collateral from his roommate reveals he has been using methamphetamine heavily for the past 3 weeks with minimal sleep. He presents with paranoid delusions that the government has implanted tracking devices in streetlights, auditory hallucinations commanding him to redirect traffic to confuse surveillance, and psychomotor agitation. Vitals show heart rate 118, blood pressure 162/98, temperature 99.8°F. Urine drug screen is positive for amphetamines. His roommate reports that prior to this 3-week methamphetamine binge, the patient had no psychiatric symptoms, was attending community college successfully, and had no family history of psychotic disorders. The roommate also notes that during a previous period of methamphetamine use 8 months ago, the patient experienced similar paranoid thinking that resolved completely within one week of stopping use.