Lyric discussion by catalyst989 

Cover art for Paranoid Opioid lyrics by Corrosion Of Conformity

My guess would be that this song is about a heroin experience that went bad and induced paranoia. The part of the song that makes me think it's about heroin is when they say, 'Burn by the spoon and now you're dying too soon.' Black tar heroin is shot up by heating up the heroin in a spoon. He probably burnt himself on the spoon which drove him into a state of panic and paranoia that he was going to dye. That's basically it.