Sneak peek: new poison enemy and medical system changes

Hello everyone!

It’s time to start sneak peeking at the next update in earnest. There is going to be a nice chunk of content additions in this update, starting with a new monster variant to spice up the medical system mini-rework we’ve been working on. Let’s take a closer look at both.

Barotrauma new creature Viperling
What combines a viper’s stripes, a Spineling’s spikes, and morbusine? Find out further down.

Changes to the medical system

Never mind that bullet hole, it’s just a flesh wound. Morphine for everyone!

Barotrauma’s medical system has seen many tweaks here and there over the years, but in its current state, it still leaves something to be desired. This much is evident also in the prevalence of mods that significantly expand the medical system. We’re not quite as ambitious as that in our current rework – hence the description “mini-rework” – but we have aimed to make the different medical items more impactful, introduce stronger progression to the system as a whole, and add new late-game challenges for the medic to deal with.

To that end, we’re introducing a couple of new afflictions, such as Infected Wounds, which can be inflicted by Thresher attacks. An Infected Wound always needs treatment, as it gets worse over time. Multiple existing medical items, such as Broad-Spectrum Antibiotics and Antibiotic Glue, have been adjusted to cure Infected Wounds as well, so there should be plenty of ways to treat the affliction!

Barotrauma medical system changes infected wound affliction
Take care with those infected wounds next time you encounter threshers.

On the topic of treatment items…

  • Antibiotic Glue now has multiple uses (currently eight), so one tube can be used to treat multiple limbs. It’s also very powerful against Infected Wounds: it basically creates a minute-long immunity for the affliction on the limb that was treated with Glue.
  • Deusizine has been buffed a lot, e.g. added Stun reduction and Vigor make it more worthwhile as an end-game item.
  • Adrenaline now has a treatment use: it causes Adrenaline Rush, which instantly removes any active stun, adds some stun resistance, and forcibly keeps the patient conscious for the effect’s short (5s) duration. The purpose is for medics to quickly get someone back on their feet in combat-heavy situations.
  • Sufforin and Cyanide can now be used to cure Husk Infection as a last resort. The poison itself doesn’t disappear as the Husk Infection does, so you must be ready to cure the poisoning as well. This gives some new uses for poisons as well as creating an interesting high-risk husk cure!
Barotrauma medical system changes adrenaline rush
Adrenaline is a new combat-situation quick fix treatment.

As you might have guessed, we’ve also rebalanced opiates:

  • Opium is still a cost-efficient, yet super addictive, option.
  • Morphine has been slowed down a lot, so it’s no longer optimal for combat-heavy situations.
  • Fentanyl is still the priciest of the three, but it’s now very efficient in combat-heavy situations due to how quickly it takes effect.
  • All opiates now cause addiction and overdose much more easily, making them more risky as treatments.
Barotrauma medical system changes opiate overdose and addiction
Opiates are still powerful healing items, but now much more dangerous as well.

The medical rework ties in with our plans for additional difficulty settings – more about those in a later sneak peek post. The Infected Wounds described above will appear more frequently in the hardmode, where they will be caused not only by Thresher attacks but also untreated bleeding and burns. Expect to see some previously negligible problems to be a bigger cause for concern in the hardmode!

The Viperling

We also wanted to introduce a new monster to create novel medical emergencies, and specifically to put some of our many poisons more in the spotlight. Enter the Viperling, a Spineling variant that shoots venomous spikes. Specifically, this new long-range enemy can inflict you with Morbusine poisoning.

Multiple morbusine spike hits are needed for the poisoning to take effect, so getting hit once or twice doesn’t mean instant death. It is still a much more dangerous enemy than the regular spineling, so it spawns only in later levels, starting from the Hydrothermal Wastes in a campaign. Once you get that far, be on the lookout for morbusine-green spinelings and have your med kit on hand. (If you have no suitable supplies around, the viperling luckily drops the ingredients to its own antidote when looted.)

Barotrauma new creature viperling, swarming
The new viperlings in action.

The medical mini-rework and the Viperling are included in our next update, coming in the late spring. Stay tuned for more sneak peeks in the coming weeks!


  • March 1, 2024
    Hydraulic Anvil


  • March 1, 2024
    Coleman Clement

    Will this update also include the permadeath option? I am hyped for that

    • March 11, 2024

      yes it will

  • March 2, 2024
    Alexander Pirie

    Looking forward to it, keep up the good work.

  • March 8, 2024
    Finn Kirby

    Looking like a promising update! Keep up the good work!

  • March 16, 2024
    Vladimir Utkin

    Great update, I think. The fact that you took up medicine in the game is very good, it’s really worth working on, and not only on it, because for such a serious game, I think it’s very arcade-like in many aspects, although I think it’s for the better , because not everyone likes, like me, to suffer with crazy mechanics and literally study medicine so as not to die from a banal wound. Good luck with your game development, we’ll be waiting. Don’t forget about translating content into other languages ​​hahaha.

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