Starfinder SRD >Game Mastering >

Afflictions

Curses, diseases, drugs, and poisons can all have effects on a character that continue long past the character’s first exposure. This deterioration in physical or mental health is often represented by what is called a “progression track.” Diseases and poisons each have default progression tracks whose steps have specific rules consequences; drugs use the relevant poison track (for example, drugs that affect Wisdom use the Wisdom poison track). Some specific afflictions have their own unique progression tracks defined in their stat blocks. Curses generally do not use progression tracks—their effects continue until they’re cured without progressing through stages.

Before an individual is subjected to an affliction, she is considered healthy in terms of the affliction’s progression track, if any. When initially is targeted by an affliction, she must succeed at a saving throw to avoid its effects; if she fails, she is subject to the affliction. If the affliction has a progression track, she is no longer considered healthy with respect to that affliction and immediately gains the effects of the first step on its progression track. For diseases, this is the typically the latent state; at this step, the victim can pass the disease along to others if it’s contagious, but generally suffers no ill effects from it herself. For poisons, the first step on the progression track is usually the weakened step. A truly deadly affliction might cause the victim to start further along a progression track than normal.

Diseases and poisons each have a listed frequency specifying how often a victim must attempt subsequent saving throws to prevent the affliction from progressing. Success could help the victim recover (see Curing an Affliction below); failure means that the victim moves one step further along its progression track, gaining the effects of the next step and keeping all previous effects. A character using a drug must attempt a saving throw each time she uses that drug. Victims typically fail voluntarily, progressing along the drug’s progression track in exchange for benefits, and withdrawal from the drug acts as a disease (see the stat block for Addiction).

Each progression track has an end state—a point at which the affliction has progressed as far as it can. Once an affliction has reached its end state, the victim keeps all current effects (but doesn’t suffer further effects) and can no longer attempt saving throws to recover from the affliction (see below). By default, diseases, poisons, and drugs have an end state of dead, but some afflictions have less severe end states, while others might have no end state, allowing victims to continue attempting saves.

Some afflictions cause the same effects as a condition (such as sickened). Effects that modify, prevent, or remove those conditions do not apply; only effects and immunities against the appropriate affliction apply.

Curing an Affliction: Diseases, drugs, and poisons can be cured if they are treated before the victim reaches the end state. In the case of a disease, the victim must fulfill the conditions in the disease’s Cure entry (usually succeeding at one or more consecutive saving throws). Each time she does so, she moves one step back toward healthy; once she reaches healthy, she is cured. Poisons and drugs work differently—fulfilling the cure condition (or reaching the end of a poison’s duration) removes a poison from the victim’s system, but she remains at the same step on the track and recovers gradually. For every day of bed rest (or two nights of normal rest), a victim moves one step toward healthy. This rate of recovery is doubled by successful Medicine checks (see Long-Term Care), though tenacious poisons might require a longer recovery period.

Curses can be cured only by fulfilling the unique cure conditions listed in their individual stat blocks or through magic.

Usually, the spell remove affliction immediately cures a victim of an affliction (moving the victim of a disease, drug, or poison to a healthy state on its progression track). However, once a disease or poison has reached its end state, only the most powerful magic or technology (such as miracle or wish, or in the most extreme cases, reincarnate or a regeneration chamber) can remove its effects.

The individual lines of information in affliction stat blocks are described below. Those marked “Optional” appear only if relevant.

Name: This lists the name of the affliction.

Type: This shows the type of the affliction, such as a curse, disease, drug, or poison. Where applicable, this line also states in parentheses the means by which it is contracted, such as contact, ingestion, inhalation, or injury. Afflictions that have multiple methods of contraction indicate this here.

Contact A contact affliction is delivered by any contact with bare skin, which generally requires an attack against EAC if the intended target is unwilling. A contact affliction can also be injected like an injury affliction. Contact afflictions often take 1 minute or longer to take effect.

Ingested An ingested affliction is delivered by tricking the intended target into eating or drinking it. Ingested afflictions often take 10 minutes or longer to take effect.

Inhaled An inhaled affliction is delivered the moment a creature that breathes (and isn’t wearing a space suit or suit of armor that filters out such toxins) enters an area containing such an affliction. Most inhaled afflictions fill a volume equal to a 10-foot cube per dose. A creature at risk can attempt to hold its breath while inside such an area to avoid inhaling the affliction. There is a 50% chance each round a creature holding its breath doesn’t need to attempt a saving throw against the affliction (see Suffocation and Drowning).

Injury An injury affliction is delivered through damage to the target, usually via a slashing or piercing kinetic attack dosed with the affliction. These afflictions often take effect immediately.

Save: This indicates the type of saving throw necessary to avoid contracting the affliction, as well as its DC. Unless otherwise noted, this is also the saving throw to avoid the affliction’s effects once it is contracted.

Addiction (Optional): Typically only applicable to drugs, this line lists the saving throw type and DC to avoid addiction. See Diseases for more about how addiction works.

Track: This line indicates the progression track used once a character is affected by the affliction.

Onset (Optional): Some afflictions have a variable amount of time before they set in. Creatures that come into contact with an affliction with an onset time must attempt a saving throw immediately, and if they fail, they suffer the appropriate effect after the onset time has passed. The creature then must continue to attempt saving throws against the affliction’s effects as normal.

Frequency: This is how often the periodic saving throw must be attempted after the affliction has been contracted. If the affliction lists an amount of time after its frequency—such as 1/minute for 6 minutes—that means its effects last for only that amount of time, regardless of whether the affected creature ever succeeds at a saving throw. Such an affliction cannot be cured via successful saving throws; after its duration ends, the victim remains at her current step on its progression track until she receives the benefit of remove affliction or a similar effect.

Effect (Optional): This line lists the affliction’s special effects, if any, beyond the effects of its appropriate progression track.

Cure (Optional): This indicates how the affliction is cured. Usually, this is number of consecutive, successful saving throws. Even if an affliction has a limited frequency, it might be cured earlier if the affected creatures succeeds at enough saving throws. Afflictions without a cure entry can be cured only through spells such as remove affliction.

Curses

Curses are magical afflictions and usually have a single effect, though some curses use tracks like diseases and poisons do. Removing a curse requires either using remove affliction or fulfilling a special condition that varies by curse (and sometimes differs between individual applications of the same curse).

A curse’s Cure entry defines the actions needed to remove the curse. These actions might vary, at the GM’s discretion.

Sample Curses

Curse of Lethargy

Type Curse; Save Will DC 20
Effect In combat and other stressful situations, the victim is affected as if by a slow spell and is immune to effects that would increase its speed.
Cure the victim must hustle (see Overland Movement) for 4 consecutive hours each day for 1 week; it must perform this movement to reach a specific destination.

Curse of the Miser

Type Curse; Save Will DC 20
Effect Each week, the victim loses 10% of its net worth through strange mishaps.
Cure the victim must donate 20% or more of its net worth selflessly, not just to remove the curse.

Curse of the Ravenous

Type Curse; Save Will DC 20
Effect the victim treats each hour as a day for starvation and thirst and is immune to effects that prevent the need for sustenance or that remove starvation or thirst.
Cure the victim must drink only water and eat only flavorless gruel for 1 month.

Curse of the Vainglorious

Type Curse; Save Will DC 20
Effect After failing an ability check, attack roll, saving throw, or skill check, the victim takes a –2 penalty to that rolls of that type for 1 minute (treat each individual skill check, ability check, and saving throw separately) and can’t try again on rolls of that type. This means the victim can’t take 20.
Cure the victim must spend 1 month humbly and obediently apprenticing to a master in one of its fields of expertise.

Curse of the Zealous

Type Curse; Save Will DC 20
Effect Each combat, whenever the victim would take its first hostile action, it is instead confused for 1d4 rounds.
Cure the victim must take no hostile actions for 1 month of active adventuring.

Diseases

Diseases are typically inhaled contagions (though these are usually filtered out by a standard space suit or suit of armor) or injury contagions. If a disease lacks a Cure entry, its progression may be irreversible without powerful magic or technology, but a successful casting of remove affliction usually prevents further deterioration. Physical and mental diseases have separate tracks.

Physical Disease Track

Healthy—Latent—Weakened—Impaired—Debilitated—Bedridden—Comatose—Dead

  • Latent The victim has contracted a disease. She suffers no ill effects yet, but if the disease is contagious, she can pass it on.
  • Weakened The victim is sickened and fatigued.
  • Impaired The victim is exhausted. Whenever she takes a standard or full action, she must succeed at a Fortitude save at the disease’s DC or lose the action and become nauseated for 1 minute.
  • Debilitated Strenuous actions cause the victim pain. If she takes a standard action, she immediately loses 1 Hit Point.
  • Bedridden The victim is awake and can converse, but she can’t stand on her own or take any other actions or reactions.
  • Comatose The victim is unconscious and feverish, and can’t be woken.
  • Dead The victim is dead, and her corpse may still be contagious.

Dexterity Poison Track

Healthy—Sluggish—Stiffened—Staggered—Immobile—Dead

  • Sluggish The victim takes a –2 penalty to Reflex saves and Dexterity-based ability checks, attack rolls, and skill checks; the DCs of her spells and special abilities decrease by 2; and she becomes flat-footed.
  • Stiffened The victim loses her Dexterity bonus to her Armor Class, and she can’t take reactions.
  • Staggered The victim is staggered but can take purely mental full actions.
  • Immobile The victim is helpless and can take only purely mental actions.
  • Dead The victim dies.

Constitution Poison Track

Healthy—Weakened—Impaired—Debilitated—Unconscious—Dead

  • Weakened The victim takes a –2 penalty to Fortitude saves, Constitution checks, and Constitution-based DCs. Every time the victim attempts a Fortitude save against the poison—whether he succeeds or fails—he loses Hit Points as per on initial exposure.
  • Impaired The victim takes an additional –2 penalty to the affected checks, and the DCs of his spells and special abilities decrease by 2.
  • Debilitated Strenuous actions cause the victim pain. If he takes a standard action, he immediately loses 1 Hit Point.
  • Unconscious The victim is unconscious and can’t be woken by any means.
  • Dead The victim dies.

Mental Disease Track

Healthy—Latent—Weakened—Impaired—Befuddled—Disassociated—Comatose—Dead

  • Latent The victim can pass on contagious diseases but suffers no ill effects.
  • Weakened The victim is shaken, and the DCs of his spells and special abilities decrease by 2. He can no longer cast his highest level of spells (if any).
  • Impaired The victim is flat-footed and no longer adds his mental ability score modifiers when calculating number of uses per day of abilities dependent on those scores, including bonus spells per day. The DCs of his spells and special abilities decrease by an additional 2. He can no longer cast his 2 highest levels of spells (if any).
  • Befuddled The victim begins losing his grasp on thought, reality, and self. He has a 50% chance each round to take no relevant actions, instead babbling randomly, wandering off, or talking to unseen parties.
  • Disassociated The victim is almost entirely disconnected from reality. His mind filters and twists all external stimuli into strange forms. He can no longer tell friend from foe and can’t willingly accept any aid (including healing) from another creature unless he succeeds at a Will save against the disease’s DC.
  • Comatose A victim rendered comatose by a mental disease has lost all grip on reality and entered a dream world. He can’t be woken.
  • Dead The victim is dead, and his corpse may still be contagious.

Sample Diseases

Addiction

Type disease (drug use); Save see specific drug
Track physical, mental, or both (see specific drug); Frequency 1/day when not using the drug
Effect If a creature takes a drug while it has progressed beyond healthy on the drug’s progression track, the DC of the saving throw against addiction increases by 2. A creature can attempt a save against an addiction only on a day when it hasn’t taken the drug. Each day spent without using the drug decreases the addiction’s DC by 2, to a minimum of the starting DC, but using the drug again, even once, returns the DC to its highest value. Each drug addiction is a separate disease.
Cure 3 consecutive saves

Blinding Sickness

Type disease (ingested); Save Fortitude DC 16
Track physical; Frequency 1/day
Effect At the impaired state, the victim also becomes permanently blind.
Cure 2 consecutive saves

Bubonic Plague

Type disease (inhaled or injury); Save Fortitude DC 17
Track physical; Frequency 1/day
Cure 2 consecutive saves

Cackle Fever

Type disease (inhaled); Save Fortitude DC 16
Track mental; Frequency 1/day
Cure 2 consecutive saves

Demon Fever

Type disease (injury); Save Fortitude DC 18
Track physical; Frequency 1/day
Effect At the impaired state, the penalties from the weakened state become permanent until the victim benefits from a restoration spell.
Cure 2 consecutive saves

Devil Chills

Type disease (injury); Save Fortitude DC 14
Track physical; Frequency 1/day
Cure 3 consecutive saves

Filth Fever

Type disease (injury); Save Fortitude DC 12
Track physical; Frequency 1/day
Cure 2 consecutive saves

Leprosy

Type disease (contact, inhaled, or injury); Save Fortitude DC 12
Track physical (special); Frequency 1/week
Effect progression track is HealthyLatentSluggishStiffened; sluggish and stiffened are as per the Dexterity poison track states; stiffened is the end state.
Cure 2 consecutive saves

Mindfire

Type disease (inhaled); Save Fortitude DC 12
Track mental; Frequency 1/day
Cure 2 consecutive saves

Mummy Rot

Type disease (injury); Save Fortitude DC 16
Tracks physical and mental (special); Frequency 1/day
Effect no latent state; the victim takes all penalties from progressing on both the physical and mental disease tracks
Cure the victim must benefit from two successful castings of remove affliction within 1 minute.

Red Ache

Type disease (injury); Save Fortitude DC 15
Track physical; Frequency 1/day
Cure 2 consecutive saves

Shakes

Type disease (contact); Save Fortitude DC 13
Track physical; Frequency 1/day
Cure 2 consecutive saves

Slimy Doom

Type disease (contact); Save Fortitude DC 14
Track physical; Frequency 1/day
Effect At the impaired state and beyond, penalties from the weakened state become permanent until the victim benefits from a remove affliction or restoration spell.
Cure 2 consecutive saves

Poisons

Each poison has a delivery mechanism. A character who is poisoned attempts a saving throw after the listed onset and at the listed frequency thereafter. Upon initial exposure, regardless of whether she succeeds at her saving throw, the victim loses a number of Hit Points equal to the poison’s DC – 10. If a victim is exposed to multiple doses of the same poison, she must attempt a separate save for each dose and progresses to the next state on the poison track with each failed save.

Strength Poison Track

Healthy—Weakened—Impaired—Staggered—Immobile—Dead

  • Weakened The victim takes a –2 penalty to Strength-based ability checks, attack rolls, damage rolls, and skill checks, and the DCs of his spells and special abilities decrease by 2. The victim’s total carrying capacity is reduced by two-thirds (minimum 1 bulk), and he gains the encumbered condition regardless of how much he is carrying.
  • Impaired The victim takes an additional –2 penalty to the affected checks, rolls, and DCs, and he gains the overburdened condition regardless of how much he is carrying.
  • Staggered The victim is staggered, except he can still take a purely mental full action.
  • Immobile The victim is helpless and can take only purely mental actions.
  • Dead The victim dies.

Intelligence Poison Track

Healthy—Weakened—Impaired—Animalistic—Comatose—Dead

  • Weakened The victim takes a –2 penalty to all Intelligence-based ability checks and skill checks, and the DCs of her spells and special abilities decrease by 2. If she has 1 or more levels in a spellcasting class whose key ability score is Intelligence, she can’t cast her highest level of spells from that class.
  • Impaired The victim takes an additional –2 penalty to the affected checks and the affected DCs decrease by an additional 2. If she has 1 or more levels in a spellcasting class whose key ability score is Intelligence, she can’t cast her 2 highest levels of spells from that class.
  • Animalistic The victim suffers the effects of a feeblemind spell, except her Charisma and Charisma-based skills are unaffected.
  • Comatose The victim can’t process thoughts and can’t be woken.
  • Dead The victim’s brain stops working, and she dies.

Wisdom Poison Track

Healthy—Weakened—Impaired—Confused—Comatose—Dead

  • Weakened The victim takes a –2 penalty to Will saves and Wisdom-based ability checks and skill checks, and the DCs of his spells and special abilities decrease by 2. If he has 1 or more levels in a spellcasting class whose key ability score is Wisdom, he can’t cast his highest level of spells from that class.
  • Impaired The victim takes an additional –2 penalty to the affected checks, and the affected DCs decrease by an additional 2. If he has 1 or more levels in a spellcasting class whose key ability score is Wisdom, he can’t cast his 2 highest levels of spells from that class.
  • Confused The victim gains the confused condition.
  • Comatose The victim can’t experience reality and can’t be woken.
  • Dead The victim’s brain stops working, and he dies.

Charisma Poison Track

Healthy—Weakened—Impaired—Pliable—Catatonic—Dead

  • Weakened The victim takes a –2 penalty to Charisma-based ability checks and skill checks, and the DCs of her spells and special abilities decrease by 2. If she has 1 or more levels in a spellcasting class whose key ability score is Charisma, she can’t cast her highest level of spells from that class.
  • Impaired The victim takes an additional –2 penalty to the affected checks and DCs. If she has 1 or more levels in a spellcasting class whose key ability score is Charisma, she can’t cast her 2 highest levels of spells from that class.
  • Pliable The victim has little sense of self and goes along with nearly any order or suggestion. Creatures attempting Bluff, Diplomacy, or Intimidate checks against her automatically succeed, though Diplomacy checks to improve her attitude still have the normal DC.
  • Catatonic The victim loses agency and can’t interact with anything.
  • Dead The victim loses autonomic functions and dies.

Sample Poisons

Black Lotus Extract

Type poison (contact); Save Fortitude DC 20
Track Constitution (special); Onset 1 minute; Frequency 1/round for 6 rounds
Effect progression track is HealthyWeakenedDebilitatedDead
Cure 2 consecutive saves

Blue Whinnis

Type poison (injury); Save Fortitude DC 14
Track Constitution (special); Frequency 1/round for 2 rounds
Effect progression track is HealthyWeakenedUnconscious; no end state.
Cure 1 save

Deathblade

Type poison (injury); Save Fortitude DC 20
Track Constitution; Frequency 1/round for 6 rounds
Cure 2 consecutive saves

Green Lotus Extract

Type poison (contact); Save Fortitude DC 18
Track Charisma (special); Onset 1 minute; Frequency 1/round for 6 rounds
Effect progression track is HealthyWeakenedImpairedPliablePliable. The second pliable functions as an end state.
Cure 1 save

Id Moss

Type poison (ingested); Save Fortitude DC 14
Track Intelligence; Onset 10 minutes; Frequency 1/minute for 6 minutes
Cure 1 save

Insanity Mist

Type poison (inhaled); Save Fortitude DC 15
Track Wisdom; Frequency 1/round for 6 rounds
Cure 1 save

Shadow Essence

Type poison (injury); Save Fortitude DC 17
Track Strength; Frequency 1/round for 6 rounds
Effect At the impaired state, the penalties from the weakened state become permanent until the victim benefits from a restoration spell.
Cure 1 save

Ungol Dust

Type poison (inhaled); Save Fortitude DC 15
Track Charisma; Frequency 1/round for 4 rounds
Effect At the impaired state, the penalties from the weakened state become permanent until the victim benefits from a restoration spell.
Cure 1 save

Drugs

Drugs are a special kind of poison that grant a beneficial effect right away but also move the user a single step down the associated poison track. However, the user doesn’t lose Hit Points, even if the drug functions as a Constitution poison. Taking a drug also exposes the user to the addiction disease, with a DC that depends on how addictive the drug is. If a character is dosed with a drug against his will, he can attempt a Fortitude save against the drug’s DC. If he succeeds, this negates both the drug’s beneficial and negative effects, as well the chance for addiction. Immunity to poison or a similar effect prevents a character from experiencing the drug’s beneficial effects, and removing or suppressing a drug’s negative effects with restorative spells also cancels the benefits.

Sample Drugs

Dreamshiver

Type drug (ingested or injury); Save Fortitude DC 18; Addiction DC 18 (mental and physical)
Track Constitution
Effect 50% chance of falling unconscious (as per the Constitution poison track state) for 1d4 hours or +8 morale bonus to saves against fear for 1d20 minutes.

Hyperleaf

Type drug (ingested or inhaled); Save Fortitude DC 12; Addiction DC 12 (physical)
Track Strength
Effect +2 morale bonus to saves against mind-affecting effects for 1 hour.

Megaopiate

Type drug (ingested, inhaled, or injury); Save Fortitude DC 20; Addiction DC 20 (mental and physical)
Track Strength
Effect +4 morale bonus to saves against pain effects and gain DR 5/— for 1 hour.

Transdimensional Pesh

Type drug (ingested or inhaled); Save Fortitude DC 20; Addiction DC 20 (physical)
Track Dexterity and Wisdom
Effect +2 morale bonus to saves against fear for 1 hour and gain 2 Stamina Points per level. (Any Stamina Points exceeding the user’s maximum are lost first and can’t be recovered; any remaining are lost the next time the user rests to recover Stamina.)