How many painkillers are too many?

[piddy3825]

Just had an interesting run where i suffered three simultaneous sprain injuries which i treated all three with pain killers, so that would be six pain killers all at one time followed almost immediately with 2 more simultaneous spain injuries which i treated with pain killers. so that was 10 pain killers in about 10 minutes.  I would think that somehow that many pain killers ought to have some kinda ill effect, idk?  the game wont just let you take pain killers unless your injured, but it will let you take enough that should or would kill you irl?  yet, i was able to move like normal and was even able to sprint.  At least i would think that 10 pain killers would make you really tired and you would have to sleep or something.

[TWM]

Over the counter pain killers - paracetamol, aspirin or NSAIDs like ibuprofin - don't make you sleepy or drowsy.

However, they do take your liver time to process, which is why you don't want to mix painkillers with alcohol. The toll it takes on your liver might damage it, in extreme cases leading to acute liver failure.

But I'm not a doctor, biochemist or apothecarist, so I wouldn't be able to tell you which dose would lead to chronic problems later down the road, and at what point an overdose would spell acute liver trouble.

[piddy3825]

3 hours ago, TWM said:

Over the counter pain killers - paracetamol, aspirin or NSAIDs like ibuprofin - don't make you sleepy or drowsy.

 

I would presume that the pain killers in the game aren't OTC drugs but rather prescription drugs based on the representation of the pill bottle.  Otherwise I would assume the dev's would have labeled the bottle aspirin.  So for the sake of discussion, lets say those pain killers are all are powerful opiates, i think i might have some issues if i just popped 10 pills...  

[wathman]

The afflictions system is simplistic, so the remedies are also simplistic which I just make myself accept as game mechanics and try not to read too far into it since more realism would just cause more tedium.  So if we start down the realism path here, based on the pill bottle representation, an opioid painkiller is most likely, though not exclusively so. You can get Rx strength NSAIDs that tend to be more potent than OTC, and some have increased side effects and risks which make them Rx only. Also, since the painkillers work instantaneously on the first dose, that would be more in line with how an opioid drug would make a person feel.

Where realism breaks down is that sprains, strains, etc. are painful because there is tissue damage and swelling involved. Some opioid painkillers like percocet do have a NSAID component that is a NSAID and has anti-inflammatory properties, but this does not instantly reverse that damage. Painkillers will stop the pain, but 6-8 hours later when it wears off, it will hurt again.  Also, in the absence of painkillers, it's possible to just sleep off these injuries with a couple of hours of rest which is not very realistic, but necessary otherwise these injuries would have to lay you up for days to simulate reality.  

The other major remedy in this game, "antibiotics" also gets kind of ridiculous with its simplicity.  Get bitten by a wolf > fail to prevent infection > need antibiotics. That isn't so bad. Eat "rusty" peaches > get food poisining > pop 2 antibiotics and sleep 10 hours > problem solved? Food poisoning can be caused by more than just bacteria though it is a typical cause. In order to get bacteria to cause food poisoning from a can, it would have to be there when it was canned, or the can would have to be damaged or breached to allow bacteria in.  This is why you aren't supposed to eat food from old dented cans since the bacteria that causes botulism can get in, produce toxin, and kill you after eating it. The game just simplifies the whole process by saying all cans will get banged up and breached just by sitting on a shelf. Eat too much predator meat > get intestinal parasites > take 10 doses of the same antibiotics you use for everything else > get healed up? Antibiotics are intended to kill bacteria, not parasites. Most typical antibiotics that work on typical food poisoning bacteria will do nothing for a parasite.  

And just to be nitpicky, there is no reason for a caduceus to be on an antibiotics bottle. It is a medical symbol that has fallen out of use by every major medical organization except the US Army medics, and groups or individuals who just don't know any better. The main reason is that its origin in Greek mythology isn't really compatible with medicine. The more appropriate medical symbol is the rod of Asclepius which is what the American Medical Association and World Health Organization use as part of their logos (a single snake coiled on a staff). The main reason why the caduceus still gets associated with medicine is that the US Army and commercial organizations in health care basically think it looks cooler so they just go with it.

http://mentalfloss.com/article/30751/what-do-snakes-and-sticks-have-do-doctors

Since this is a game, visual impact is kind of important so it's unlikely that the devs would want to change the bottle appearance, the typical gamer would be more likely to recognize the caduceus, and there isn't anything else that would be universally recognized. They are already getting close to ticking off the Red Cross organization for using the iconic red "plus sign."  The ones in Long Dark are white or outline white, but other games have incurred their wrath for using the symbol without justification or authorization. 

 

[Mel Guille]

11 hours ago, piddy3825 said:

Just had an interesting run where i suffered three simultaneous sprain injuries which i treated all three with pain killers, so that would be six pain killers all at one time followed almost immediately with 2 more simultaneous spain injuries which i treated with pain killers. so that was 10 pain killers in about 10 minutes.  I would think that somehow that many pain killers ought to have some kinda ill effect, idk?  the game wont just let you take pain killers unless your injured, but it will let you take enough that should or would kill you irl?  yet, i was able to move like normal and was even able to sprint.  At least i would think that 10 pain killers would make you really tired and you would have to sleep or something.

So you're imagining a mechanic where taking more than a small number of painkillers in a short period of time would have some negative effects? That could be interesting, although it would certainly make the game more challenging. Other than reducing your rest meter, what other effects could taking excessive pain killers have? 

[Vinceofpyrenees]

11 minutes ago, Mel Guille said:

So you're imagining a mechanic where taking more than a small number of painkillers in a short period of time would have some negative effects? That could be interesting, although it would certainly make the game more challenging. Other than reducing your rest meter, what other effects could taking excessive pain killers have? 

Vomiting probably ? or Headache (that could influence ability with bow and rifle) ?

[wathman]

Something that could add interesting dynamics is addiction and withdrawal. Add a few minor positive benefits with a steep negative.  Add the ability to take painkillers without injury, and after 3 or 4 doses it helps stave off cabin fever, you gain resistance to cold and condition drops at half usual rate. As long as you continue to take painkillers regularly, the positives continue.  Once you run out or decide to quit taking, penalties kick in, -40% condition cap, increased food and water requirements, movement speed penalty that lasts at least a week.  If you find more painkillers, it becomes more likely to develop addiction again. On higher difficulties, it becomes a strategic decision if the short term gains are worth it in the overall goal of long term survival. 

[Carbon]

 As with any good opioid narcotic, the character should....like, wow, suddenly stop feeling the cold, begin sobbing uncontrollably crouched beside the little bunny's corpse in the snare then realize how gosh darn pretty the snowflakes really are when you look at them this closely and make plans to melt a bunch of them into a hot tub for when all of this 'end-of-the-world' stuff blows over.

[piddy3825]

13 hours ago, Mel Guille said:

So you're imagining a mechanic where taking more than a small number of painkillers in a short period of time would have some negative effects? That could be interesting, although it would certainly make the game more challenging. Other than reducing your rest meter, what other effects could taking excessive pain killers have? 

I like where you are going with this idea.  Imho, I would at the least expect to become very tired and wanting to sleep, definitely would expect to be a little groggy and unsteady on my feet.  I would imagine that fine motor skills would be impaired so it would be difficult to craft items or repair them, hunting prowess would be impaired, so aiming the rifle and steadying the bow would be compromised and I would expect the ability to sprint to be strictly curtailed those sort of things for sure.

[Dirmagnos]

Technically, if were talking painkillers, they shouldnt be "per use" item, but have a duration. Combined with injury severity, as all painkillers have effectiveness threshold(and dangers associated with their usage).

So when player takes painkillers it increases that pain threshold significantly, allowing to ignore either one moderate or several small injuries, but would have limited effectiveness in cases of serious injuries. With diminishing effect as time goes by.

Combined with skills(game could have a lot more skills, all with unique perks and effects, like Medicine or Bodybuilding or Toughness or Herbalism, or dozens of others that i have written down but dont remember) and advanced injuries mechanics(why i cant clean wolf bites with clean water if im fast and skilled enough to reduce infection chances) it could work well imo.