Purpose of Review <p>Violence, alcohol use, and schizophrenia spectrum disorders often co-occur, with each factor exacerbating the others. The purpose of this review is to describe the relationship between alcohol use and violent behaviors across different stages of psychosis for individuals with schizophrenia spectrum disorders, and to identify potential opportunities for intervention.</p> Recent Findings <p>Alcohol misuse and alcohol use disorder (AUD) have long been associated with an increased risk of violence among persons with psychosis, with a 2013 meta-analysis of over 100 studies concluding that recent alcohol misuse more than doubled the odds that a person with psychosis would engage in violence. Violent behavior causes major disruptions to the lives of persons with schizophrenia spectrum disorders, such as legal consequences, financial burden, loss of social supports, and worse health outcomes. Research indicates that violent behavior is more common in the early stage of psychosis, while other studies suggests that alcohol use is increasing in midlife. However, the relationship between alcohol use and violence across the different stages of psychosis, including the prodromal period, early psychosis, and chronic stages of psychosis, is unclear.</p> Summary <p>This narrative synthesis review found that rates of violent behavior decrease from 25-33% in early stages to 10-20% in later stages, but rates of alcohol misuse and AUD remained more prevalent than general population rates, with estimates ranging from 20-40% based on the type of alcohol use or use disorder. As violence decreases across the lifespan of psychosis, the violence that remains appears more closely tied to alcohol use. Since both violence and alcohol use are associated with worse health outcomes, preventing either violence or substance use is expected to improve treatment outcomes for this population. </p>