I mentioned it in an earlier suggestion but I’d like to see the pharmaceuticals standardized and improved.
First off, all the brand name drugs should be standard generic - brand name drugs are actually fairly rare except for more recent ones where their monopoly hasn’t expired yet. There is a difference between brand names, brand drugs, generic names and generic drugs – a brand drug is one made by the original researcher and producer. They have a patent for a certain period before other companies are allowed to produce generic drug equivalents. This is why brand drugs are more expensive; during the patency period they can basically charge whatever they want, and rarely change prices even after the patency period is over.
A brand name is whatever shows up on the bottle, and are used for both brand drugs and generic drugs – for example, Zoloft (a brand name for a brand drug) is sertraline, the original, but might be sold by the company. The Apotex version (a company that only produces generic drugs) might have the brand name Apo-Sertraline, and the generic name sertraline. Generic names are internationally recognized while brand names often change and might be unrecognizable around the world; some drugs are just so well-known that it becomes a household name. Ie. Aspirin is a brand name, the generic name is acetylsalicylic acid, which you’ll see on every bottle. Advil is a brand name, the generic name is ibuprofen. Then you get even more confusion at the same drug with different specific uses-- Advil and Motrin are the exact same thing, but marketed towards different “types” of pain (inflammation vs. muscle pain mostly).
It might be a bit confusing because the some of the generic names are unfamiliar, but so are a lot of things to a lot of people in Cataclysm. Just look at the description and it tells you exactly what it is. Your character in Cataclysm would 90% of the time be picking up a jug, bottle or vial labeled with the GENERIC name, not the brand name.
So anyway, a list of drugs that I’d like to see changed, taken from jsons. Capital letters are brand names:
All the rest are already generics.
A second suggestion: drug interactions.
Many drugs interact with not only drugs but also over the counter or unscheduled food/drink. There are different types of interactions possible:
Synergistic: Two chemicals combine to have an effect in one or more drugs greater than the sum of the parts. Think of it like 1 + 1 = 3. Biggest examples by Cataclysm standards: Alcohol + benzodiazepines or narcotics (alcohol actually beefs up the effect of MANY drugs) will cause extreme sedative effects on the central nervous system and can cause respiratory paralysis, coma or death.
Additive: Two chemicals, while not interacting in a direct way, have a combined effect on the body. 1 + 1 = 2. A stimulant like methamphetamine won’t directly interact with methylphenidate, but take them both and you’ll see a proportionate increase in CNS stimulation. This typically causes fewer harmful side effects than synergistic interactions and can be controlled much easier. Taking both aspirin and ibuprofen will be more effective against pain than either alone but also cause more liver, kidney, and gastro toxicity.
Potentiation: Two (or more) drugs interact to form effects that otherwise wouldn’t happen when the drugs are taken individually, usually one of the drugs is inactive and harmless normally. 1 + 0 = 2. Consider it a ‘catalyst’ for side effects- this is one of the most dangerous interactions possible. Grapefruit juice potentiates a lot of drugs, due to it having strong effects on the metabolism of chemicals in the liver. It can have wildly different effects on many drugs, including narcotics, benzos, blood pressure medications, etc.
Antagonistic: The effect of one drug cancels out, minimizes, or otherwise reduces the effect of another. 1 + 1 = 0. These are used typically as antidotes in the case of overdose. Example - ethanol antagonizes the effect of methanol poisoning, the drug naloxone is used as an antidote in case of heroin overdose.
The most obvious way to include drug interactions in Cataclysm is to start with these 4 different types and add them to the json entries to link them together-- though having not looked at the drug code myself I’m not even sure how it’s handled. Sight unseen I’m going to assume they’re simply a counter on the player object; for a synergistic effect it’s an easy thing to simply dramatically boost up the level of the drug in the body – leading to very easy accidental overdose, which is exactly what happens in RL. In the json you could include either a type of consumable (the flag) or a specific one-- let’s use alcohol and morphine as an example.
The USE_ACTION of all alcohols is ALCOHOL, so it’s easy to just change morphine rather than all the alcohols. Let’s also add an additive reaction for all other opiates. At the end of the morphine entry you could add:
"interaction_synergistic" : ["ALCOHOL"],
"interaction_additive" : ["OPIATE"],
To make it more complex, you could change it to WEAK, STRONG interactions - strong obviously being more dangerous.
One more thing - every drug has a ceiling effect, this is where therapeutic benefits stop and side effects start increasing. Adding side effects to every drug entry would be fairly easy, and have their chance of occuring rise the more you go into overdose, giving people a warning that they’re sucking back far, far too many opiates before their breathing stops, for example. Ideally you would have flags for every drug giving ALL of their effects- opioid analgesia for example - and then compare and contrast the effects when you take them. Taking 2 different types of analgesics would be more effective than taking 2 opioids, because the body can only work with a certain amount in the body at once. Stimulants, taken together, with alcohol, or in large doses, causes heart palpitations (flutter), chest pain, pupil dilation, and other effects and eventually heart attack and/or death. There’s no need to hard code anything but the actual effects, and shift the rest to jsons.
Anyway, just some ideas.