Euthanasia

Item Icon
Pickup Quote	"Needle shot"
Entity ID	5.100.496
Character Appearance
Item Pool	Curse Room Devil Beggar Treasure Room Curse Room Treasure Room
Quality	3
Item Tags
Collection Grid	(page 5, column 11, row 1) (page 5, column 12, row 1)
Unlock Method	Defeat Delirium as Lilith

Euthanasia is an unlockable passive item added in The Binding of Isaac: Afterbirth †.

Effects

• Adds a chance to fire needles which deal triple Isaac's tear damage.
  • Needles will instantly kill regular enemies and cause them to burst into 10 more tears in all directions.
  • The chance to fire a needle depends on luck.
  • The formula used to determine the chance is: $\frac{1}{30-\lfloor \mathit{L}\mathit{u}\mathit{c}\mathit{k}\times 2\rfloor }$
    • At base luck (0), the chance is 3.33%, maxing out at 100% at 14.5 luck.
  • The formula used to determine the chance is: $min(\frac{1}{30-\lfloor \mathit{L}\mathit{u}\mathit{c}\mathit{k}\times 2\rfloor },25\%)$
    • At base luck (0), the chance is 3.33%, maxing out at 25% at 13 luck.
  • The tears released upon an instant-kill also have a chance to be needles, though these ones do not have the instant-kill ability. They do retain the 3× damage, however.
• This item belongs to the Spun set. Collecting three items from this set will transform Isaac into a buff berserker.

Notes

• The needle tears can kill enemies that are normally invincible, such as Peep's eyes, Death's Heads, and Stoneys.
• The needle tears can kill Stone Grimaces and Spikeballs, allowing Isaac to permanently remove any obstacle in a room.
  • The needle tears can kill Bomb Grimaces, dropping 10 unlit Throwable Bombs. This can make it detrimental to shoot at them, since they are usually provided as a tool rather than an obstacle.
• The tears in the burst are larger than normal but do not have a damage bonus.
• Unless piercing is obtained, Knights will still block the needles if shot from the front.

Interactions

• Brimstone / Dr. Fetus / Mom's Knife / Technology / Trisagion: No appearance change, tear burst, or instant kill, but triple damage still works.
• Brimstone / Dr. Fetus: Enemies killed by a needle burst into normal tears.
• Cricket's Body / The Parasite: Needles will always split into needles, although some of them may be incorrectly displayed as regular tears. Burst tears will split as normal.
• Godhead: The aura of a needle tear will also do triple damage, but does not cause tear burst or instant kill.
• Ipecac: No tear burst or instant kill, but triple damage still works.
  • Enemies killed by a needle burst into ipecac shots.
• Jacob's Ladder: The electric arcs released from a needle shot also retain the needle's instant kill and tear burst properties.
• Little Horn: If a tear has both the Euthanasia and Little Horn effects and instantly kills an enemy, it does not cause a tear burst.
• Tech.5: The tears that Isaac fires work normally, and the laser has a chance to deal triple damage with no other effects.
• Tech X: Completely overrides Euthanasia. No triple damage, no tear burst, or instant kill.
  • Laser Rings will sometimes deal triple damage/instantly kill regular enemies, and enemies killed by needles burst into normal tears.
• Technology: Killed enemies can burst into black tears normally.
• Technology 2: The tears that Isaac fires work normally, but the laser is completely unaffected.
  • The laser has an extremely high chance of executing normal enemies.
• Tiny Planet: Euthanasia's tear bursts will follow the orbit in 2 close groups of 5 tears. One group travels clockwise and the other travels counterclockwise.
• Spirit Sword: Each swing of the sword has a chance to do 3x damage and instantly kill a non-boss enemy, causing a tear explosion.

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Trivia

• Euthanasia is the act of intentionally ending a person or animal's life to end their pain and suffering. It is usually carried out by an injection, hence why this item has the appearance of a needle.
• Euthanasia is the only syringe item that points upwards; all of the other syringes point downwards.
• Euthanasia and Experimental Treatment are the only 2 syringe items that need to be unlocked.

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