Drugs & Addiction in 5th Ed - D&D - Addiction Rules and Withdrawal Symptoms

Oct 5, 2026

Uploaded by Oliver

This document introduces a 5th Edition Dungeons & Dragons ruleset for handling illicit substances in gameplay, written for the Eberron setting but usable in other 5E worlds by excluding or modifying the provided examples. It defines an “Addiction Save” (Wisdom) when a drug is taken, a matching “Withdrawal Save” (Constitution) when doses are missed, and consequences that escalate by addiction level.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Addiction framework

Addiction Save and failure consequences

Withdrawal Save, timing, and symptom duration

Addiction levels

Minor

Mild

Moderate

Severe

Extreme

DRUGS & ADDICTION IN 5TH ED . D&D In the world of Dungeons and Dragons, players may come across as many unsavoury and illicit substances as there are in the real world, perhaps even more so due to the fantastical element of magic. At the time of writing, no published books (and very few homebrew creations) cover rules or sample narcotics for this element of gameplay, which is what this document intends to do. Note that these rules were written for the 5th Edition Eberron setting, as seen in the sample drugs & their origins, but these rules can be applied to any 5th Edition D&D setting, so long as the sample narcotics are excluded or modiﬁed to have a place in the world. Whenever a creature takes a drug, ontop of the drug's effects, they must make a Wisdom saving throw, applying their normal proﬁciencies & bonuses. This Wisdom save will be referred to as an "Addiction Save". On a failed save, their "addiction level" will increase, these levels and their effects are described ina later section. On a successful save, their addiction level does not change. The DC of the Addiction Save is different for each addiction level. Users will also take a penalty to this save depending on the addictiveness of the drug, the"Addiction Modiﬁer" line for each drug. Once a creature has become addicted, they are forced to take a dose of the drug at a certain frequency, depending on the addiction level. If they do not, they must make a Constitution saving throw,(referred to as a "Withdrawal Save"), also applying the drug's addiction modiﬁer. On a failed save, they suffer serious withdrawal symptoms, different for each addiction level. On a successful save, they take less severe withdrawal symptoms, & their addiction level is reduced. The Withdrawal Save and symptoms come into action at the end of the user's next long rest. The symptoms, unless otherwise mentioned, last until the user takes the drug again, even if long or short rests would restore the user normally, for example, a point of exhaustion. ADDICTION LEVELS Whenever a creature takes a drug, they have a chance to slip into an addiction, determined via the Addiction Save. This addiction forces the user to take the drug once every so often, lest they risk suffering withdrawal symptoms via a Withdrawal Save. These symptoms come into action at the end of the user's next long rest. A table below succinctly summarises the 5 proposed levels of addiction: Minor, Mild, Moderate, Severe, & Extreme. This table states the DC for the Addiction Save to enter the level of addiction, the Withdrawal Save DC required to leave it, and the frequency of dosage. Remember, unless otherwise mentioned, the conditions caused by Withdrawal Symptoms can only be removed by taking the drug, or by magical means, even if the penalty can normally be removed by resting. For example, a point of exhaustion, or the loss of hit die. Since Extreme is the highest level of addiction, an Extreme addict does not need to make Addiction Saves when taking the drug. ADDICTION LEVELS Level Save DC Frequency Minor 4 7 Days | Mild | 6 | 5 Days | | --- | --- | --- | | Moderate | 10 | 3 Days | | Severe | 12 | 2 Days | | Extreme | 16 | 1 Day | Addictions can be more easily treated via magic. An addict can be completely cured of all current withdrawal symptoms, and addiction levels by the spell Heal, or other similar effects. Greater Restoration cures an addict can also be cured of all current withdrawal symptoms, and removes two addiction levels, whilst Lesser Restoration removes current withdrawal symptoms, and one addiction level. A substance addiction can also be detected by Detect Poison and Disease. DRUGS & ADDICTION IN 5TH ED . D&D 1 MINOR ADDICTION | A user may not even realise that they have a minor level addiction. The consequences are slight, and the user is only required to take the drug infrequently.
Withdrawal Save Fail: At end of next long rest: The user takes 2d6 poison damage.
Withdrawa

FAQs

What roll determines whether a creature becomes addicted after taking a drug?

After taking a drug, the creature makes an “Addiction Save” using Wisdom. A failed save increases the creature’s addiction level, while a successful save leaves it unchanged.

What happens if an addicted creature misses a required dose?

If the creature does not take the drug at the required frequency, it must make a “Withdrawal Save” using Constitution when the next long rest ends. Failure causes serious withdrawal symptoms that worsen by addiction level; success reduces the severity and can reduce the addiction level.

How are addiction levels structured and managed over time?

The rules define five addiction levels—Minor, Mild, Moderate, Severe, and Extreme—each with a DC to enter, a DC to leave, and a dosage frequency. Extreme is the highest level, and an Extreme addict does not need to make Addiction Saves when taking the drug.

Oct 5, 2026

Uploaded by Oliver