Health management

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Perhaps Horizon's biggest change is health - how much of it the player has, how much the player can gain, how the player gains health, how much health enemies have. With this in mind, it might be wise to invest in your medical skill early on to better manage this.

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.

  • 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
  • Combat 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
  • Antibiotics renamed to Advanced Cure-X
  • Combat stimpaks/RadAway/Advanced Cure-X 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

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.

Medical Supplies[edit | edit source]

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":

  • Are 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
  • Skills needed to craft: Chemistry (60), Medical (60)

Ultra Combat Stimpaks

  • Same as Combat Stimpaks except:
  • Provide twice the healing per second
  • Skills needed to craft: Medical (120)

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 usable 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"
  • Skills needed to craft: Chemistry (30), Medical (30)


  • Can NOT be applied while in combat
  • Any active healing will continue to work if you do engage in combat afterward
  • 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
  • Primarily this is created through crafting (only very rarely appears on loot or vendors)
  • Doesn't require any skill to craft
  • Can be crafted at a cooking station, chemistry lab or in your personal toolkit

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
  • Skills needed to craft: Medical (30)

First Aid Kit Same as Bandages except:

  • They heal a fixed amount for more than triple what bandages do over the same duration
  • Slowly heal 20% limb damage
  • Requires different materials to craft
  • Skills needed to craft: Medical (60)

Trauma Kit

  • They heal all limb damage (this is the only way to heal limb damage, other than doctors, and to a lesser extent First Aid Kits)
  • 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)
  • Doesn't require any skill to craft

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
  • Skills needed to craft: Chemistry (30), Medical (30)

Antibiotics - Basic / Antibiotics - Herbal

  • Only Cures Infection
  • Skills needed to craft: Medical (30) or Survival (30)

Poison Antidote / Poison Antidote - Herbal

  • Cures Poison (Poisons from creatures now last longer and slowly damage you)
  • Grants Poison Immunity for 1 minute
  • Skills needed to craft: Medical (40) or Survival (60)

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 100% limb damage over 15 minutes
  • Grants +40 rad resists, +40 Energy Resists, +5 Cryo Resists for 15 minutes
  • No longer has a disease risk
  • Requires an Adrenaline Injector instead of a regular Blood Pack
  • Skills needed to craft: Medical (50), Survival (50)

Jet Coffee

  • Cures Lethargy
  • Caffeinates
  • +20 AP for 20 minutes
  • Skills needed to craft:
Atomic Scotch
  • Cures Parasites
  • +5 Poison/Fire/Cryo Resists
  • Skills needed to craft:

Loaded B12 Shot

  • Cures Weakness and Lethargy
  • Restores 1 AP per second for 2 minutes
  • Caffeinates
  • Skills needed to craft:

Herbal Remedy

  • Increases resistances to ALL illnesses for 1 hour
  • Requires Survivalist rank 3 to craft
  • Skills needed to craft:

Skeeto Tonic

  • Cures Parasites
  • +5 Poison Resist and +20 AP for 30 minutes
  • Skills needed to craft: Survival (40)


  • Cures Overfatigue
  • +10 Max AP and +5 AP regen for 10 minutes
  • Skills needed to craft:

V7 Juice

  • Cures Lethargy
  • Exceptional Hydration
  • Contains 7 essential fruits and vegetables!
  • Skills needed to craft:

Melon Juice

  • Exceptional Hydration
  • Grants resistance to all illnesses, +10 Damage, Energy, and Rad Resists for 15 minutes.
  • Skills needed to craft:

Cosmic Carrot Juice

  • Hydrates
  • Grants Night Vision in exteriors, +1 Perception, +10 Damage, Energy, and Rad Resists for 15 minutes.
  • Skills needed to craft:


  • Lowers Addiction levels by a moderate amount
  • Skills needed to craft:


  • Cures Parasites
  • +10% Damage, +20 Damage Resist for 5 minutes.
  • Skills needed to craft:


  • Cures Insomnia
  • +2 Perception, +2 Agility and Water Breathing for 5 minutes.
  • Skills needed to craft:


  • Cures Weakness
  • +3 Strength and +30 max AP for 10 minutes
  • Skills needed to craft:

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
  • Chemists (XXXX) can create Pharmaceuticals from raw materials
  • Jet, Mentats, and Psycho now require XXXX 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