How do you know if someone is losing touch with reality, and has some kind of issue, or if it's just the effects of a substance (in this case, alcohol). The person I'm referring to has been an alcoholic for many years, refuses help and even fails to see there is a problem. They have been increasingly making outbursts for no reason, including accusations of physical assault when there was nothing of the sort done, constantly antagonizing people, randomly yelling or trying to cause arguments, and saying and doing very off the wall things. Is it possible that being an alcoholic for so long could create some sort of psychosis? The person in question is not particularly pleasant while sober, but their behavior becomes much worse after they have been drinking. I'm just not sure what to do at this point, so any advice would be helpful.