Substance-Induced Psychosis and Criminal Responsibility in New York: Settled Disease vs. Voluntary Intoxication

Stephan M. Carlson, MD, MBA, FAPA · Criminal Competency and Responsibility

When psychosis appears alongside drugs or alcohol, New York law splits the question in two: was the defendant transiently intoxicated, or was a substance-related condition already a settled mental disease at the moment of the act? The answer decides whether an insanity defense is even available, and the psychiatry has to be built to that distinction rather than around it. Two statutes that pull in opposite directions New York's affirmative defense of lack of criminal responsibility requires that, at the time of the conduct, the defendant lacked substantial capacity to know or appreciate either the nature and consequences of the act or that it was wrong, as a result of mental disease or defec

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