Responsible Portrayal of Addiction in System

CW: drug and alcohol use, addiction

Has anyone written or read something good about how to incorporate addiction into an RPG in a responsible, respectful, and safe way? How would you handle it in game design?

I have seen a lot of RPGs that include it - as a flaw in the World of Darkness, as a trauma in Gumshoe games, as a drawback for using combat drugs in Shadowrun, as a stress relieving mechanic in Forged in the Dark, etc.

Some things that seem a given:

  • The people playing are assumed to be adults or old enough teens that they’ve gotten core “don’t abuse drugs” “this is what addiction looks like” messages.
  • Don’t punch down. Addicts function and deserve respect as people, and many substances (painkillers, beer, weed) are fine if used safely.
  • Don’t glamorize addiction either. It’s not OK. Addiction should have realistic symptoms in a game that deals with this sort of issue, or don’t involve it at all.
  • Players still want to play a competent/interesting protagonist. Addiction doesn’t make people useless, and it would make someone two dimensional if that was their only/overwhelmingly dominant trait.
    -Content warnings and safety mechanics to the nines. Allow ANY player to veto the whole thing, etc.

Imagine a PbtA game with an “Addict” playbook or an addiction move, or a Fate game that encourages addiction aspects, etc. How would you handle it responsibly?

I worked at a crisis center for years, and I’ve seen its varying impact on hundreds of people. I just want to hear others’ perspective on how to incorporate it responsibly.

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I think that’s the core of the problem right there. If the game includes life affecting addictions then that needs to be reflected in the severity of the rules for being addicted.

I’ve been thinking a lot about “seesaw clocks” for a very different project where the needle moves towards expiration unless the character takes actions to move it back. I think that could work here where as the clock ticks down the character loses competency but they can move the needle back with a fix. Over time, if they don’t address the addiction, the clock moves faster until they are unable to keep up and their competency is severely reduced and eventually their health.

All of that is for somewhat real-world addiction. Not for a vice which I think can handled purely through role playing with maybe a +/- thrown in.

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I struggled with this in putting together some rules to play in the Fallout setting, realizing as I translated video game mechanics to tabletop rules that I was really not comfortable with turning addiction into a minigame. It seemed especially problematic to just wipe away the symptoms and consequences if you can find a doctor to pay 50 bottlecaps. Personally, I ended up just marking some consumable items as “chems” or “addictive,” figuring that it was important to acknowledge in the setting that not everything is as simple as taking a “power up,” but I left the details of what that should mean in the rules up to the reader and players. Maybe that’s a cop out, though. I’m curious to hear how others think about it.

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I don’t know that it needs to be mechanized to that degree, but of course for your case that might be the best way to include it. For my purposes, I think a story mechanic might be better.

The downsides I want to focus on have less to do with physical dependency than the effects on social life and relationships. It’s not “roll to see if you drink too much and pass out” and more “who lost all respect for you because they had to come get you when you passed out last night?”

Maybe what I ought to do is make a list of suggested addiction-related life complications for GMs to insert when they get to make a hard move, and then give the character downtime type moves that give them opportunities to wind up ensnared in those moves.

And of course explicitly allow anyone in the game to line out all this stuff at the start.

Thoughts?

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Yeah, that’s an element of Fallout that never comes up in the video game. Do you ever lose dialog options because you’re drunk or high on Psycho? Do you ever gain bad ones? No, you just adjust stats, sometimes for the better. It kind of bothers me that your social life gets BETTER when you’re drunk (whiskey = +1 Cha).

I’d leave addictive chems out of the game if I were you, or make them an optional module. I sometimes take combat drugs in Fallout video games, but I just pay the 50 caps if I get addicted. If I couldn’t pay the caps for an instant cure, I’d never take them. It’s super problematic.

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Another thought: I’m making rules for a modern era game about psychics, largely based on 20th century junk science about psychic phenomena, but not a comedy game (for that, see InSpectres).

Like your Fallout game, I’m struggling because a large part of 20th century culture surrounding psychic phenomena revolves around the use of narcotic, dissociative, and hallucinogenic drugs. And these ideas go back to First Nations practices and ancient Greek oracular use of kykeon.

Some of these substances form physical dependency and all of them can lead to psychological dependency and even brain damage and other problems. I want to assume competence with PCs but also portray drug use and dependence responsibly. The game isn’t shy about portraying mental illness and traumatic stress, but it does so in a positive way (positive meaning hopeful and respectful, not sugar coating). So I wanted to also include responsible portrayal of drug abuse and addiction - for just one or two playbooks so it can be easily lined out if need be. (I’m using so many safety mechanics and procedures here.)

So I’ve got a similar problem to your Fallout chems problem. But I really don’t want to ditch it unless there no responsible way to include it.

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I think whether it’s physical, social, or psychological you’ll need to make sure that the addiction reduces the character’s freedom in a consistent and usually inconvenient way. There are choices that an addiction will make for you and at it’s own time.

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The psychic angle is even trickier to my mind (which I don’t mean as condemnation, but with admiration that you’re thinking through this). Fallout is based on a wholly fictional setting, and I can just choose not to adapt a thing that falls flat for me from the video game; taking inspiration from real people and cultures, meanwhile, demands some consideration of how that affects them, I think. (And I’ll admit that I think this can sometimes make fantasy allegory so appealing and potentially so disingenuous. Come on, X-men, think about the implications of your setting where oppressed minorities actually can be literal time bombs.)

I honestly don’t know how I’d take on the psychic project if it were me. Do a bunch of research with real people, I suppose, if I planned to sell it. I wonder if it depends on how much you want the story to be ABOUT substance use and/or abuse, vs how much you just want to include it (potentially without gamifying it) so as to avoid whitewashing/erasure.

I’m no expert on this topic, but my gut tells me the comments on your earlier posts — about not punching down, about showing respect to people struggling with addiction and using without necessarily abusing, and about story-driven prompts over blunt mechanical penalties — sound like your head is in the right place.

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To me, including the crossover between psychics and psychotropic drugs is a net positive, but I’m limiting it to one (possibly two) of 13 playbooks so it can be lined out at game creation. It’s not the only case where I’m using playbooks as safety/content control tools.

This is the case with a LOT of stuff in this design. There’s a cop, but if a modern day suburban police officer’s relationship with their community is too uncomfortable, you can line that one out. There’s an academic playbook that I used to put all the “this phenomenon is similar to [culture’s spirituality]” stuff with explicit instructions about avoiding bad appropriation and celebrating and learning about other cultures. And if you line out that playbook, all those moves are out, and you reduce that risk in play because the other playbooks don’t even consider other cultures.

Modern day games take a lot of work, but I think it’ll pay off.

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Using compels in FATE against an addiction aspect seems pretty classic. It can cause an issue in game, but not unduly so. And still give players agency as protagonists.

Example for those unfamiliar with compels: PC is hurrying to meet a key contact. They pass a bar. GM offers compel: if character goes to bar and misses appt, they get a Fate chip which can be used later to increase a future die roll.

One dimension of addiction rarely covered mechanically is the escalating nature of addiction. Just bringing it up as a consideration, no solution comes to mind (I guess would be dependent on the actual addiction mechanic decided).

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I was thinking about this too, but I’m wary based on the way I’ve usually seen Fate played. Even though it’s not intentional, the rules would encourage players to see their addictions as bonuses or as generators of bonuses. That’s not so likely if players come at it thinking more like authors than like gamers, but I’ve certainly played Fate with more of the latter.

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IIRC there is a negative side effect of not accepting a compel, no?

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You spend 1 fate point to do so, but you get to narrate how your character awesomely avoids the harm or cost. So in the example, you could have your character drink but call the contact and change the meet time, or make a healthy decision for once, or something.

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Yeah… That is a part of Fate I have always felt uncomfortable about. (It feels like a warped (in the favor of the GM) consent mechanic…)

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The player always has to consent that a compel is fair, though. If you think that compel is unfairly prescribing something that you wouldn’t want as a difficulty in the game, you should step out and explain why this is not what the aspect was supposed to be about, and then the GM should withdraw the compel.

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The Fate point mechanic can get a little tricky. I found that it took a fair amount of practice as a Fate GM before you get it right. In Fate, all PC Aspects were defined by the player, and are effectively telling the GM how they want their character to interact with the narrative. So, if you’ve defined your character’s Trouble aspect as “Heavy drinker”, then you are telling your GM that you want alcohol to be a complicating factor in your character’s story. You should then expect the GM to offer you a Fate point to, say, be too drunk to drive when you leave the bar.

That said, unless the game itself is about addiction, I would shy away from setting mechanics around it. Addiction is a medical condition, not a vice. I’m fine with mechanics around a character’s vices (e.g. “When you’re intoxicated, take a -2 penalty,”) but not so much with medical conditions.

I’ve seen addiction mechanics in games where the rules feel bolted-on and weren’t well thought through. Such mechanics don’t seem to have a lot of respect for people in the real world that struggle with addiction. (I’m looking at you, Pathfinder.)

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I think this depends on the goals of the system. For a game about a party of player characters that mostly collaborate toward an external goal (but go through some character development along the way) I think Blades does it pretty well. The use of Fate compels people describe above makes sense to me, too. In both instances. addiction is a source of complications that impact (without distracting from) the thing the game is mostly about. Vices matter in Blades because stress is an important part of your ability to complete scores, and overindulging might mess up your standing with contacts (who you need to complete scores).

Here it sounds like you are considering designs where addiction would be a more significant focus of play. I would say this only makes sense to do if your game is primarily about character development and relationships, because giving a topic like this nuance requires committing a lot of air time to it.
Also, addiction and recovery have a strong component of inner struggle and I think relatively few games handle inner conflict well. [Here’s a thread on the topic.]

Using systems that have the tools to make inner conflict an interesting component of play, here are two ways I think you could do it:

Example 1:
Dogs in the Vineyard Initiation, where the challenge the would-be Dog is facing is addiction. The player scripts the conflict as the version of themselves who is able to get clean. The GM plays out all the internal and external challenges to doing so.

Each time the GM pushes forward a die, they say something like:

  • You find a bottle of whiskey when cleaning up an old camp site. No one else is around and they don’t expect you back for a couple of hours.
  • Things are going well, which only heightens your anxiety. You know deep down it’s only a matter of time until you blow it.
  • You’re into a another initiate who grew up apostates, he admits that he has a bottle of bitter church wine stowed in his pack. He wants to give it up and come clean, but he’s worried he’ll lose his shot at becoming a Dog.

Example 2:
The Burning Wheel, where a player character has a belief about addiction. “I have become a drunk, and I failed my queen; it cannot happen again.”

The GM introduces NPCs and situations that challenge that belief and test its limits:

  • Introduce a rival who drinks too much, but has avoided the consequences (from luck or the strength of their name).
  • Introduce situations with intense social pressure to drink, a diplomatic dinner or long sea journey.
  • If the player character drinks, their actions push a relationship with someone they rely on to a breaking point.
  • If they sober up, they still face judgement from others. Some friendly NPCs go cold, others act condescending or start to pry.
  • Fallout from past mistakes causes economic hardship.
  • Introduce an NPC that they need help from now, but have wronged in the past.
  • They make a small mistake, unrelated to their addiction, and others assume the worst.
  • Give them a reason to need privacy or trust (an important piece of intrigue, for example) and then have the people around them read their secrecy as evidence of a relapse.

I think it would take a lot of buy-in and agreement about expectations to have either of these play out smoothly, perhaps especially the Burning Wheel example, because of the prolonged focus on a difficult topic.

Another reason I included extended examples was to make a point (and clarify it for myself). If you are dealing with topic like addiction in detail, it makes sense to me to not make it a numeric system about manipulating your odds of success (+1/-1 to a stat, etc). Instead, it can frame the stakes of your character’s decisions and the consequences of your actions.

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IIRC the Infernal playbook in Monsterhearts is for the most part about addiction?

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I really am a fan of how Blades handles it. The Vices start off as ignorable but, as Trauma grows, you really stop being able to ignore them.

I like that a lot:

  • It escalates, and does so almost invisibly to the character.
  • It starts as a mere “vice”, which we all have.
  • It is used to blow off steam, which is likely healthy! But, overdoing it is bad.
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Hello. I would like to start out that Godbound at least issues an opinion on one of it’s godly powers “Madness”. They ask the GM and players to discuss the issues of mental health, if need be, with each other as some people maybe a diagnosis or know some who does.

But the other godly power “Intoxication” carries no such opinion.