If Paulie is given Psycho, the Lone Wanderer will be awarded with bad Karma. Giving him additional Psycho will give the Lone Wanderer even more negative Karma. Eventually, he will die from an overdose.
Negative Karma (-100) every time he is given Psycho.
Cindy Cantelli, Paulie's wife and owner of A Quick Fix, will be relieved when Paulie dies because she can finally make a profit off of her products due to Paulie no longer taking chems from her store. One Psycho is enough to make Paulie OD, to exploit the Karma loss, enter a new dialogue as soon as the previous closes to give him additional ones. Paulie usually goes to an unused room on Midship Deck to use the Psycho, the first on the right as one enters from the stairwell, with a Hard locked filing cabinet.