Long-term drug usage has the potential to deteriorate a person’s ability to discern reality. The average person is usually able to discern rational and irrational fears, but drug/alcohol abuse does something to both our conscience and our brain that makes that ability increasingly difficult. George was convinced his entire family was out to get him, in particular they wanted his money (money he didn’t actually have). All they actually wanted was to be helpful, but he was convinced they had ulterior motives. Substance abuse can cultivate paranoia in two particular ways.
On the one hand drugs and alcohol do impact our biology. Our brain works to regulate our emotional responses and conform them to our rational thoughts, but long-term abuse of drugs and alcohol impacts this alignment and regulation. In many cases it works to produce extreme euphoria. So, meth produces a dopamine flood that is substantially more than normal (more than most other drugs too), and so a user will feel pleasure well beyond what their rational circumstances or even physical state logically aligns with. In his book Methland, Nick Reding describes a man, Roland Jarvis, whose use of meth enabled him to work for sixteen hours without needing a break. He writes:
Roland Jarvis used to have a good job at Iowa Ham in Oelwein. It was a hard job, “throwing” hundred-pound pans full of hog hocks into a scalding roaster and pulling them out again, a process he likens to playing hot potato with bags of sand. But he made eighteen dollars an hour, with full union membership and benefits…Jarvis had a girlfriend he wanted to marry, so he took double eight-hour shifts at Iowa Ham, trying to put away as much money as possible. On days that he worked back-to-back shifts, Jarvis had a trick up his sleeve: high on crank, with his central nervous system on overdrive and major systems like his digestive tract all but shut down, Jarvis could easily go for sixteen hours without having to eat, drink, use the bathroom, or sleep. (49-50)
The drugs produce a sort of euphoric flood that helps him to feel good well beyond what his body can actually endure. His brain is not aligning his emotional state with the reality of his situation, in this case his physical stamina and endurance. Eventually it catches up with him; Reding writes:
Unaware of how hard his body has been working, and the deficit at which he is operating, Jarvis begins to show signs of physical depletion. Shaking hands, severe sweats, muscle cramps, and shortness of breath are all symptoms of impending withdrawal. (52)
His body cannot sustain the disconnect with reality and as the drugs wear off his body reacts to the harm he has caused himself. Yet, the emotional state may still not be aligned with reality, for when the withdrawal sets in so too does the paranoid delusion that he is being followed. Reding continues:
So, too, does the paranoid conviction set in that he’s being followed – like the belief that a black helicopter was hovering above his house. (This hallucination is common; I heard the exact same story from dozens of addicts in Alabama, Illinois, Kentucky, Georgia, and California).
Long-term substance abuse, like that of Roland Jarvis, can actually deteriorate that part of the brain which tests reality and discerns rational fear from irrational fear.
Drug and/or alcohol abuse can also cultivate paranoia through our consciences. Built into all of us is the sense of right and wrong, we call it our “conscience.” It’s our God-given awareness of general morality. When we persistently and consistently violate our conscience we feel guilt, a guilt that we are desperate to suppress. The conscience cries out for attention and resolution to our own hypocrisy, and one of the ways it does this is to tempt us to believe that everyone knows we’re doing wrong. Paranoia sets in this case as a signal that we must resolve sin in our lives, we must repent. If we continue to violate our conscience and ignore that signal the paranoia can increase. In other words, unaddressed guilt can lead to paranoid thinking as we increasingly fear exposure – this is especially true when illegal activity is involved.
In substance-induced paranoia there is hope that with detox the paranoia may dissipate. If it doesn’t medication may be necessary to help realign emotions with reality. Substance-induced psychosis can be a serious issue that puts the user and those around them at risk of serious harm, so it is best to seek intensive care, treatment, and oversight in such cases. Not all paranoia, however, is directly related to the brain’s chemistry. It’s important to wrestle with the conscience and to probe a person’s sense of morality.
The apostle John tells us that fear has to do with punishment. In such cases the resource we offer to those whose paranoia is a result of a guilty conscience is the love of God in Christ. John says it this way:
There is no fear in love, but perfect love casts out fear. For fear has to do with punishment, and whoever fears has not been perfected in love. (1 John 4:18)
Perfect love casts out fear and there is no more perfect love than the love of God displayed in the giving of His Son for sinners. There is no guilt that cannot be absolved in the cross, no sin that cannot be forgiven, no person who cannot be cleansed. There is a love greater than all our sin which deals with divine consequences, takes our punishment, and sets us free. Pointing to such hope can be an encouragement and incentive to addressing guilt, and resolving paranoid thoughts.
Not all paranoia arises from the same causes. There is a kind of paranoia which is the development of a deterioration in the brain. There is also a paranoia that fears exposure of sin and criminal activity. Treating them both the same will not help individuals. Carefully assessing the situation, seeking wise counsel, and seeking to address real sin will be a means to navigating the relationship between addiction and paranoia. It’s an important relationship to learn to navigate.