This article contains: Health Management, Medical/Survival Supplies, Radiation, Doctors, and Survival changes.
Horizon has a very balanced and finely-tuned health system, that completely changes how health is managed in Fallout 4.
The overabundance of cheap and easy-to-get healing in the Fallout games really trivializes any sense of a true survival feel, and it needed to change. The only way to heal in Horizon, is through actual medical treatment. Eating food or sleeping to heal off all your injuries or limb damage is gone.
Note that all healing is now fixed values, instead of percentages. This is why Horizon's healing system works so well.
Even though regaining health is more challenging, your max health pool will be higher than normal. Some players might jump to the conclusion that this larger health pool seems to make the beginning of the game easier than vanilla, but you have to realize because of the fixed value healing, it does NOT help you with healing over time.
A larger health pool allows the player to have a wider buffer for dealing with injuries and taking big hits. The idea is that enemies will wear you down, but usually can't just 1-shot you at full health. This also helps counter the unrealistic "ping-ponging" of constant damage and healing.
The Core Changes to Health Management:
- All food no longer regenerates health
- All water no longer regenerates health
- Sleeping no longer regenerates health
- Leveling up no longer regenerates health (This begins working only after you gain your first level)
- Any health regeneration from perks and magazines is removed or converted into increased health pool
- The player's max health pool no longer automatically increases with each level
- Base starting health is 190 (up from 80)
- Endurance gives +20 health per point (up from +5)
- Perks and magazines give larger health pool increases
- You can only heal limbs from Trauma Kits and doctors*
- Stimpaks are rare (and expensive) and the only source of healing while you're in combat
- Item such as Bandages and First Aid Kits, can only be used outside of combat to heal yourself
- All healing is fixed values, instead of percentages
- Stimpaks/RadAway/Antibiotics are all increased greatly in cap prices
- Doctors charge significantly more for all recovery services
- Doctors have a brand new menu-driven system that charges you caps for exactly what you need cured
- Many foods and chems have adjusted buffs and debuffs
- Hunger reduces the amount of healing received when using medical supplies
- Being "Rested" gives you a bonus to the amount of healing received when using medical supplies
*Some healing items also grant a very small (2-5%) heal to leg limb damage. This is done so you can avoid getting "stuck" limping around, in case you ran out of Trauma Kits.
PLEASE NOTE: Make sure any healing effects have finished BEFORE sleeping. Sleeping will remove all healing conditions. It's recommended to actually heal after sleeping, to take advantage of the Rested buff anyway.
Gaining Maximum Health:
Temporary buffs (from food and chems) that grant max health and endurance have been removed from the game. There are reasons why these buffs cause problems (and confusion), and could not be properly fixed, so I decided it is best to remove them from occurring. Food/chems that had these buffs have been compensated in most cases, with new buffs.
Gaining maximum health is usually only gained by permanent methods instead (such as Life Giver, endurance, etc.), which also feels a bit more realistic anyway.
Healing can be achieved [and is limited] by the following:
- Stimpaks (In combat)
- Bandages, Medicated Bandages, First Aid Kits (Out of combat)
- Paying caps to a Doctor for treatments
Stimpaks are now "Combat Stimpaks":
- Is usable in combat
- They heal a fixed amount of health now
- No longer heals limb damage (with 1 exception below)
- Heals 5% leg limb damage, to allow you to recover from limping in an emergency
- Has a 50-second cooldown before you can stimpak yourself again
- Applies a debuff that reduces your radiation resistance while it's healing
- Is boosted with the Medic Perk
- All Stimpaks that were hand-placed in the world are now replaced by "Adrenaline Injectors"
- Can be obtained rarely from loot (such as First Aid containers), and sometimes NPCs
- Can be purchased from doctors, and can also still be crafted with the right skills
New - Ultra Combat Stimpaks
- Same as Combat Stimpaks except:
- Can only be crafted if you have Medic 4
- Provide twice the healing per second
New - Adrenaline Injector
- NOTE: This item technically replaces ALL vanilla "Stimpaks"
- This item is consumed when reviving fallen companions
- Can be used on yourself if you wish, gaining 1 stack of adrenaline (better used for crafting though)
- Heals 5% leg limb damage (like the original stimpak, it's still useable as an emergency limb recovery)
- Trauma Kits (and some other recipes) require this item for crafting
- NPCs who are carrying these, can use it on themselves to heal
- Sorting/icon is categorized under "Chems"
New - Bandages
- Can NOT be applied while in combat
- Any active healing will continue to work if you do engage in combat afterwards
- They heal a fixed amount of health over 1m10s
- Another Bandage (or First Aid Kit) cannot be used again while you are currently healing
- Applies a -40% action point refresh reduction for the duration of the heal
- Applies a debuff that increases the damage you take by 20% for the duration of the heal
- Is not boosted with the Medic perk
- Primarily this is created through crafting (only very rarely appears on loot or vendors)
New - Medicated Bandages
- Same as Bandages except:
- They heal a fixed amount for double what standard bandages do over the same duration
- Requires different materials to craft
- Requires Medic Rank 1 to craft
New - First Aid Kit
- Same as Bandages except:
- They heal a fixed amount for more than triple what bandages do over the same duration
- Requires different materials to craft
- Requires Medic Rank 2 to craft
New - Trauma Kit
- They heal all limb damage (this is the only way to heal limb damage, other than doctors)
- They heal a very small fixed amount of your health (this is mainly just so you can see it working easier)
- Is usable in combat
- Applies very slowly over time
- Applies a -30% action point refresh reduction
- Cannot sprint for the first 30 seconds of healing
- It's available mainly through crafting (very rarely do you see any from loot)
Many new items are created (or changed) to cure specific illnesses or conditions:
- Nuka Cola Quantum: Now also cures Lethargy
- Psychotats: Now also cure Parasites
- Calmex: Now also cures Insomnia
Antibiotics are now "Advanced Cure-X":
- This is the default Antibiotics, but is reflected to show it cures everything
- Can be sometimes be purchased from doctors
- Can be very rarely found in loot
- Requires Chemist rank 4 to craft
New - Antibiotics - Basic
- Only Cures Infection
- Requires Medic rank 1 to craft
New - Antibiotics - Herbal
- Only Cures Infection
- Requires Survivalist rank 1 to craft
New - Poison Antidote
- Cures Poison (Poisons from creatures now last longer and slowly damage you)
- Grants Poison Immunity for 1 minute
- Requires Medic Rank 2 -or- Survivalist Rank 2 to craft
New - Glowing Blood Pack
- "Emulate the aspects of the glowing creatures of the wasteland."
- Existing Glowing Blood Packs are obsolete and replaced by a new item when crafted
- The new Glowing Blood Pack no longer heals but instead restores 90% limb damage over 15 minutes
- Grants +40 rad resists, +40 Energy Resists, +10 Cryo Resists for 15 minutes
- No longer has a disease risk
- Requires an Adrenaline Injector instead of a regular Blood Pack
- Can now be crafted with Chemist rank 1 -or- Recipe: Survival Skills rank 6
New - Jet Coffee
- Cures Lethargy
- Caffeinates
- +20 AP for 20 minutes
- Requires Survivalist rank 2 to craft
New - Atomic Scotch
- Cures Parasites
- +5 Poison/Fire/Cryo Resists
- Requires Survivalist rank 1 to craft
New - Loaded B12 Shot
- Cures Weakness and Lethargy
- Restores 1 AP per second for 2 minutes
- Caffeinates
- Requires Medic rank 2 to craft
New - Herbal Rememdy
- Increases resistances to ALL illnesses for 1 hour
- Requires Survivalist rank 3 to craft
New - Skeeto Tonic
- Cures Parasites
- +5 Poison Resist and +20 AP for 30 minutes
- Requires Recipe: Survival Skills rank 3 to craft
New - Rebound
- Cures Overfatigue
- +10 Max AP and +5 AP regen for 10 minutes
New - V7 Juice
- Cures Lethargy
- Exceptional Hydration
- Contains 7 essential fruits and vegetables!
New - Melon Juice
- Exceptional Hydration
- Grants resistance to all illnesses, +10 Damage, Energy, and Rad Resists for 15 minutes.
New - Cosmic Carrot Juice
- Hydrates
- Grants Night Vision in exteriors, +1 Perception, +10 Damage, Energy, and Rad Resists for 15 minutes.
New - Fixer
- Lowers Addiction levels by a moderate amount
Psychotats
- Cures Parasites
- +10% Damage, +20 Damage Resist for 5 minutes.
Calmex
- Cures Insomnia
- +2 Perception, +2 Agility and Water Breathing for 5 minutes.
Buffout
- Cures Weakness
- +3 Strength and +30 max AP for 10 minutes
Other additions to medical crafting recipes:
- A new component that is used for crafting medical supplies, called "Pharmaceuticals"
- Pharmaceuticals are used to craft Antibiotics, Trauma Kits, Stimpaks, and other items
- Certain drugs (psycho, jet, mentats, med-x, daytripper) can be broken down into Pharmaceuticals
- Rank 4 Chemists can create Pharmaceuticals from raw materials
- Jet, Mentats, and Psycho now require Chemist Rank 2 to craft
- Some liquor can be turned into Antiseptic, and requires certain ranks of "Recipe: Survival Skills"
- Generic beer can be distilled into Antiseptic and requires Party Boy/Girl rank 1
- RadAway and Stimpaks require additional materials to craft now
- Adrenaline Injectors are required to craft some medicial supplies
- Adrenaline Injectors can crafted with the proper ranks of "Recipe: Medical Knowledge"
- Refreshing Beverage can be craft with Chemist Rank 1 -or- Recipe: Survival Skills Rank 7
Doctors are completely overhauled in Horizon. They offer a brand new menu-driven system to cure exactly what you need cured.
- Doctors now charge you caps based on exactly what's cured and how much was cured
- This allows you to use doctors at any time without feeling like you're randomly either overpaying or getting too good of a deal
- Upon requesting a cure from the dialog, a menu will pop up showing you all of your injuries and how much it will cost
- You can choose to "Cure Everything" at once, or individually cure individual conditions
- Curing everything at once, will cure rads first so that all your health is fully healed
- Curing everything at once can potentially be more cost effective (and easier/faster to deal with)
- There's a minimum caps cost of 30 caps per selection (which is why it's recommended to "Cure Everything" if possible)
- Health: 1 cap per health healed
- Rads: 0.5 caps per rad healed
- Limbs: 0.5 caps per total percentage needed to be healed
- Disease: 20 caps per disease
- Poison: 20 caps per poison
- Addiction: caps cost based on the amount of total addiction have you (NOT the number of individual addictions) - maxes at 400 caps
- The doctor fade in/out scene runs faster now
- Far Harbor doctors should now be compatible with the menu system
- The dialog selections are updated to reflect the new system
- The doctor at the Institute no longer gives free healing and uses the doctor menu
I always found that radiation didn't feel like the threat it was supposed to be. There was way too much Radaway, doctors charged basically nothing to remove it, and you can simply bypass it by just wearing power armor or a hazmat suit.
Radiation should be something to be avoided if possible. You will find yourself needing a real doctor to cure yourself of any sizable radiation damage.
- RadAway will rarely drop from loot or containers, but continues to exist in static locations
- RadAway cures half the amount of rads now, but the immunity debuff is reduced to 20 minutes
- RadAway can still be increased by the Medic Perk, but the amount is reduced rebalanced
- RadAway, drugs, and alcohol, no longer dehydrates the player (since I've made curing rads harder now, there's no need to penalize the player with annoyances like this)
- RadAway also no longer causes starvation (again, this is a pointless annoyance to the player.. removed)
- RadAway no longer benefits from Chemist or BioComm mods (this should never have been like this to begin with)
- Rad-X now lasts for 10 minutes
- The price for buying Radaway is greatly increased
- The price for curing radiation from doctors is increased, and scales based on the exact amount of rads you need cured
- RadAway takes a few extra ingredients to craft it
- Food and water that cause radiation damage now cause more radiation damage
- All drinkable water sources now cause some radiation damage and are considered dirty water (which is everything except Purified Water bottles)
- Filling bottles at any water source (including water pumps) now gives dirty water
- Radiation resistances on Hazmats suits is reduced, and they also have reduced "built-in" radiation reduction
- Radiation resistances on Power Armor is significiantly reduced. If you want rad resists on PA, you must craft lead lining and/or rad scrubbers
- Rad Scrubbers no longer remove radiation from food, but instead give you rad resists
New - Rad-Off
- This is a smaller version of RadAway that Survivalists can take advantage of
- Removes 100 Rads
- Suppresses immunity for 20 minutes
- -2 Strength for 5 minutes
- Requires Survivalist rank 1 -or- Recipe: Survival Skills rank 7 to craft
New - Ultra RadAway
- Removes 300 Rads (plus the bonus from medic)
- Requires Medic rank 3 to craft
New - RadAway Chew
- Removes 50 Rads slowly over time
The default survival system in FO4 wasn't necessarily bad, but it needed some tuning to make it not feel as awkward and annoying to deal with.
Eating a good meal should prevent severe hunger for a fair amount of time. You shouldn't have to suffer through a day or 2 worth of debuffs in order to make good "caps" usage out of cooked food. It doesn't make sense.
I've rescaled the food/water consumption so the first stage lasts much longer. But the total amount of food/water you need to eat (over time) remains exactly the same. In other words, it now feels much smoother without pestering you so often.
In short: If you eat a big meal (real cooked food that gives ~100 value) when it says you're "Hungry", it will actually use most/all of that value, and you will be "Well Fed" for longer. Don't bother eating before that though, or you waste food.
Changes to the Status Icons:
- Icons for all debuffs can come in varying degrees of color
- Yellow/Orange/Red icons are based on how severe the debuff is
- Beneficial buff icons will remain as the normal UI color (the color you have it set to)
- Hunger/Thirst ranges from: yellow, orange, orange, red, red
- It's recommended to use a pale color UI to get the most out of any text colors
Changes to Survival Mode:
- The time it takes to reach the first hunger level is ~24 hours (up from 6 hours)
- The food points required for the first hunger level is 4 times higher (roughly 96 food points, i.e. caps value.)
- Every 12 hours after that, you will reach the next hunger level (similar to before.)
- The total amount of "food points" (which is based on the caps value) that is needed to stop hunger per hour, remains exactly the same.
- The total time it takes to reach the last "starve to death" level is slightly extended to 3 days (up from 2.6 days)
- The time it takes to reach the first thirst level is 8 hours (the max level remains the same; water per hour remains the same.)
- "Fed" is now "Well Fed", since that level range effectively lasts much longer.
- "Peckish" is now "Hungry"
- "Hungry" is now "Very Hungry"
- The time while sleeping to check food/thirst is increased to match a standard 24-hour eating cycle.
- The penalty of engaging in combat is reduced slightly.
- Hunger reduces the amount of healing received when using medical supplies
- Being "Rested" gives you a bonus to the amount of healing received when using medical supplies
- Sleep deprivation also reduces your XP gained
- Lethargy's penalty is slightly lowered.
- Being over-encumbered no longer damages you, but reduces your agility by -5
- Molerat disease is reduced to 2 hours and then it will wear off (that icon needed to go.)
- The game mechanic of "requiring companions to be healed or they go home" is removed*
*This game mechanic has some issues with it, so I disabled it for now. I may attempt to overhaul this game mechanic in the future.
If you are using my Timescale addon:
Keep in mind that these changes aren't simply reduced in half (or doubled), because sleeping still passes normal time. Only the average time you're awake needs to be accounted for.
- (Timescale Addon Only): The timescale is reduced in half to 10 (instead of 20)
- (Timescale Addon Only): Sleep deprivation debuffs are more severe (doubled in most cases, since being awake is always half the time)
- (Timescale Addon Only): While sleeping, hunger/thirst now advance at normal rate (was 75%)
- (Timescale Addon Only): Food/thirst advance at 1.5x the normal value per hour
- (Timescale Addon Only): Vendors respawn every 5 days (instead of 7 days)
- (Timescale Addon Only): Resource Manager production occurs every 18 hours (instead of 24 hours)
Changes/Additions to Food and Water:
- Bottles of Purified Water now grant a buff of +10 Damage/Energy/Rad Resists for 15 minutes
- Bottles of Purified and Dirty Water give slightly more hydration
- Many cooked meals are worth more "food points" (i.e. caps value) now
- Cooked meals in general require a lot more ingredients to craft
- Some cooked meals have different versions now that require extra meat/crops, but give more value
- Raw meat is usually worth less "food points" now
- Most foods that give radiation damage, now give more radiation damage
- In the cooking station, all food is now categorized in 3 main groups based on perk requirements
- When you drink any beverage, it will give you back an appropriate empty bottle
NEW - Sanitized Water
- This is a type of water that falls inbetween dirty and purified
- Causes radiation damage but does not have any chance of illness
- Requires a fair amount of materials to craft
NEW - Purified Pre-war Meals
- Two different kinds of meals can be created using pre-war foods
- These cooked meals have no radiation
- +10 Damage/Energy/Rad Resists for 15 minutes (shares the same buff as purified water)
- Requires 1 purified water to craft, but also hydrates
Misc Consumable Buff Items:
NEW - Disposable Armor Augment Buffs
- These are buffs you can consume to apply a temporary augment to your armor
- Augment buffs last 30 minutes
- You can only have 1 Armor Augment buff on at a time
- Using another will remove the last effect, even if it's lower
- Disposable Ceramic Armor Plating I: +10 Damage Resist
- Disposable Ceramic Armor Plating II: +35 Damage Resist
- Disposable Insulated Armor Padding I: +10 Energy Resist
- Disposable Insulated Armor Padding II: +30 Energy Resist, +5 Fire Reist
- Ceramic Plating 1: Requires Armorer Rank 1 and Recipe: Inconceivable Rank 1 (Unstoppables magazine perk)
- Ceramic Plating 2: Requires Armorer Rank 2 and Recipe: Inconceivable Rank 4
- Insulated Padding 1: Requires Armorer Rank 1 and Recipe: Fact or Fiction Rank 1 (Tales magazine perk)
- Insulated Padding 2: Requires Armorer Rank 2 and Recipe: Fact or Fiction Rank 4
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