I’ve had to restrain people on various drugs including the dreaded PCP, while working hospital security, people who ‘keyed’ up in some way are the only ones you’ll probably be fighting. Calm logical and sane people don’t typically attack others.
But no, you do not have to KO, maim or kill a ‘keyed up’ opponent.
Leverage still works. If you are big/strong enough m, you can still over power them, et.
I called for police assistance at a place I ran.
Me - 6'3" 230-250 lbs depending upon dehydration and time of year / day .
The police officer was loosing the battle against this smaller guy.
Police 6'4" 230ish
Smaller guy about 5'6" and about 140 lbs.
I asked if he needed help or wanted me to call for help.
He said yes Help him.
I had his arm behind his back. One hand on his elbow and the other on his hand with his wrist in a 90 deg angle.
He was on the ground. I was laying on top of him.
He looked over his shoulder and said F-U and lifted his arm up.
It broke his wrist and he didn't flinch.
We rolled around for ever - probably 90 seconds to 120 seconds and then I said to the officer I would hold him while he called for more back up.
I rolled him back on top of me and loosely held him and he relaxed looking up at the blue sky.
The Officer called for back up.
He leaned over us. As his shadow crossed his body I could feel it tightening up.
Another for ever probably another 120 seconds or so.
We had rolled to within a few feet of the road on the parking lot pavement.
His hand was nothing more than a flail and it still worked well that way.
He bit the cop multiple times and broke skin each time.
The first car rolled in hot. Damn near ran me over. As I looked up form the noise of the first tire passing, I was looking up at the body of the car above me and read wheel moved my hair as he was turning and stopping.
I balled up and started screaming I was helping the officer. - this was on repeat.
As each officer rolled in I was continuing you the above process not moving from my ball.
Finally a sergeant says you can get up and move away. I did.
It took 6 police to cuff him.
It took the same 6 to get his legs cuffed as he hurt many more officers while they tried to get him into a vehicle.
They took four officers to get him in even after legs and hands were cuffed together.
He dislocated shoulders and hips and would spin and bit or flail.
Physics that day was not enough unless you wanted to maim the person. * See broken wrist * And even then it was not enough.
So yes there are cases where it depends.