Abstract: At 11:30 a.m. on May 28, 2021, an employee working as a laborer for a temporary staffing service was working on a crew with five coworkers as a laborer performing cleanup work near a highway on-ramp. A coworker on the crew drove a work van to transport everyone to this worksite. At approximately 6:45 a.m. the crew arrived and began the morning by picking up tumbleweeds, debris, and trash from the side of the highway. At approximately 11:30 a.m., the employee began feeling thirsty, dizzy and experienced increased sweating. He walked towards the van to grab a bottle of water. The employee's symptoms worsened as he walked towards the van. As he arrived at the van, the employee collapsed on the ground. The employee was hospitalized to treat a metabolic encephalopathy and pneumonia due to amphetamine use, which was detected in the employee's system.