A patient on a medical detox unit reports tactile hallucinations ('My skin is crawling with ants.'). What is the best nurse response?

You are hallucinating. There are no bugs on your skin.

What you are experiencing must be very frightening, but I do not see any ants.

When someone in detox experiences tactile hallucinations, the best approach is therapeutic communication: validate what they’re going through and respond with empathy rather than disputing the perception. The most effective reply acknowledges that the experience is frightening and calmly states that you do not see the ants yourself. This validates the patient’s distress, preserves trust, and invites them to share more—setting the stage for a full withdrawal assessment and safety monitoring without escalating distress.

After this validation, you’d want to assess for withdrawal severity and safety (e.g., other symptoms, risk of delirium tremens) and monitor vitals, while continuing supportive, nonjudgmental communication. Other responses are less appropriate: denying the perceptual experience can undermine trust; attributing it to drinking can blame and stigmatize; and physically brushing off the sensation is dismissive and unsafe.

You feel the ants because of excessive alcohol consumption.

Be still and I'll brush the ants off.

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