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I started thinking about a variant of a melee attack cantrip like booming blade that would allow you to regain some lost health. The cantrip I came up with is this:

Evocation cantrip
Casting time: 1 Action
Range: 5 feet
Components: V, M (a weapon)
Duration: Instantaneous

As part of the action used to cast this spell, you must make a melee attack with a weapon against one creature within the spell's range, otherwise the spell fails.

On a hit, the target suffers the attack's normal effects, plus 1d4 necrotic damage. The target makes a Constitution saving throw against your spell save DC. On a failure, you heal for an amount equal to the necrotic damage dealt. On a success, nothing else happens.

The spell's damage increases as you reach higher levels.

The necrotic damage increases by 1d4 when you reach 5th level, for a total of 2d4 damage. This damage increases by 1d4 at 11th level and again at 17th level.

The issue with this cantrip is that the DMG (p. 284) clearly says that a cantrip shouldn't offer healing.

So the question is if

  • a low extra damage/healing output,
  • a Constitution saving throw
  • and the possible addendum of resolving the weapon attack damage first, as to prevent the PC from abusing it on wildlife and easy targets

are enough to make it balanced?

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    \$\begingroup\$ Please don't edit with updates after answers come in. You can this meta on how to ask a good homebrew question. \$\endgroup\$ – NautArch Apr 30 at 18:21
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    \$\begingroup\$ Also, welcome to RPG.SE! Take the tour if you haven't already and see the help center if you need more guidance. Good Luck and Happy Gaming! \$\endgroup\$ – Someone_Evil Apr 30 at 18:21
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    \$\begingroup\$ What class or classes would you give it to? \$\endgroup\$ – Benjamin Olson Apr 30 at 22:11
  • \$\begingroup\$ I've tried to reword this to match the definition of another cantrip like booming blade, and I made it an evocation cantrip (since that's what this is, I believe). You should probably clarify what classes this is for though. \$\endgroup\$ – Riker Apr 30 at 22:32
  • \$\begingroup\$ Would you consider adding in some negative effect to help balance it? I'd suggest something like -1 to max HP per use recovered at a rate of +1 max HP per long rest to impact the viable frequency of use. Alternatively adding in some flavor text about a mouth forming on the handle as a conduit and including a risk along with the healing (eg "caster must also make a constitution saving throw. On failure takes 1d4 piercing damage.") makes use of the spell a less clear cut win with it being possible to lose HP in the attempt. \$\endgroup\$ – Myles May 1 at 15:58
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It's probably unbalanced.

Let's take a look at what other things allow you to restore hit points at first level:

  • Cure Wounds (requires a spell slot and action, restores 1d8 + change).
  • Healing Potion (costs 50 gp, requires an action, restores 2d4+2).
  • Goodberry (requires an action, restores 1 hp).
  • Healing Word (requires a bonus action and spell slot, restores 1d4 + change).

A cantrip that lets you use the same action to both make an attack and also heal up to 4 hp is certainly more powerful than any of these options for 1st level characters. A cantrip that lets you heal for even 1 hp would be strictly superior to a Short Rest, so probably even that would unbalance the game a little.

As you've written this spell, it should be at least a 1st level spell.

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  • \$\begingroup\$ Comparison to Spare the Dying as a contrip might be helpful compared to Cure Minor from 3.X. \$\endgroup\$ – Slagmoth Apr 30 at 18:25
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Definitely unbalanced

I can only speculate as to designer intent, but the mentioned admonition from DMG is likely because healing should consume resources, putting a practical limit on the amount of healing that can be done each day. As such, there is unlikely to be any extenuating circumstance that might balance a cantrip (no resource use) that allows healing.

What you might be able to get away with is changing the healing component of your cantril to Temporary Hit Points. Even getting temps so easily could be unbalanced (most other sources of temps are either spells (False Life) or class features (Dark One's Blessing, which also requires killing the target rather than just hitting it), so the spell is probably still unbalanced, though the Con save requirement might help. You might also add the limitation that the caster can only benefit from these temps once per creature damaged with the cantrip.

Further, note that the other weapon based cantrips (Booming Blade and Green Flame Blade) don't provide their additional damage until some other condition is met (adjacent targets or the target voluntarily moves). Guaranteed additional damage, even just a d4, might be unbalanced, even without the heal/temp component. As such the Con save should prevent the extra damage completely.

Two options would thus be:

On a hit, the creature must attempt a Con save. On a failed save, the creature takes 1d4 necrotic damage and you gain the same amount of temp HP. You may only gain this temp HP once per 24 hours from any given creature.

Or:

On a hit, the creature must attempt a Con save. If the creature fails the save, it takes 1d4 necrotic damage and, the target's soul is marked. If the creature dies within the next minute, you gain 1d4 temp HP. Each creature may only be marked once in this fashion, additional failed saves merely reset the one minute duration of the mark.

Either option restricts the benefit to once per creature (similar to DOB), and places the additional damage behind a condition (the Con save). The damage and temp HP could probably be raised to a d6 without significantly unbalancing the cantrip at this point. Since temp HP can't stack, the cantrip is more difficult to exploit, and the first option (immediate temps) is more powerful by far (allowing you to benefit multiple times per combat, similar to DOB).

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  • \$\begingroup\$ I like the idea of temp hit points, probably let them expire after 1 minute. Change the damage to nothing extra on first level and temp 1d4 if creature dies within 1 minute, then add dice on 5th, 11th and 17th, 1d8 for damage and extra 1d4 for temp... I'm gonna let this post cook for a while and add a new one later \$\endgroup\$ – CrazyRabit Apr 30 at 22:55
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    \$\begingroup\$ @crazyribit even better would be to play test before posting to get some actual play outside of the theoretical here. \$\endgroup\$ – NautArch Apr 30 at 23:37
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    \$\begingroup\$ Since temporary hit points never stack, it'd only ever be a small buffer against damage rather than a source of infinite healing. Definitely an improvement over the original. \$\endgroup\$ – V2Blast May 1 at 0:37
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    \$\begingroup\$ On the note "healing should consume resources", note that even Epic characters using the Boon of Spell Mastery can only choose a 1st level sorcerer, wizard, or warlock spell to use freely. Druid, Cleric, and Bard are excluded - the classes that get access to cure wounds and healing word. If a cantrip can do something a "21st level character" cannot, it's probably too powerful. \$\endgroup\$ – gatherer818 May 1 at 1:57
  • \$\begingroup\$ @gatherer818 This is technically not correct. If you play a Divine Soul Sorcerer or a Celestial Patron Warlock they both get access to Cure Wounds, which counts as a spell of their spell list, and thus would be eligible for the Boon of Spell Mastery. Very edge case I know, but oh so technically a 20th level character could access resourceless healing. \$\endgroup\$ – Jake Conkerton-Darby May 1 at 15:07
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The cantrip is too easily abused.

Even without comparing this to official cantrips, your suggested homebrew cantrip is unbalanced. The benefits (regaining hit points) stack with themselves, and the cantrip can be used indefinitely against any creature. What you have here is a "bag of rats" scenario, in which the player has a benefit-per-hit ability that they can easily exploit by hitting many weak creatures.

For example, suppose a level 1 wizard literally carries around a bag of rats. Each rat is a CR 0 creature with 10 AC, 1 hit point, and a -1 Constitution save bonus. For the sake of simplicity, let's assume each casting of the cantrip has a 50% chance to successfully kill a rat and gain +1d4 hit points.

In 1 minute (10 rounds), if the wizard casts this cantrip each round, then they can can regain about ~5d4 HP. This expends no materials, and heals more than a consumable healing potion. And in 5 minutes, the wizard can regain ~25d4 hit points, which is cheaper than spending hit dice during a short rest, even at higher levels.

When the wizard runs out of rats, they can find new ones, likely for a lower cost than a healing potion or rest at an inn. This simple cantrip can break the system's hit point economy.

Can it be balanced?

As with any "bag of rats" exploit, you can prevent abuse by making the benefits non-cumulative, such as granting temporary hit points that don't stack with themselves.

Furthermore, these temporary hit points would need a very short duration. Otherwise the cantrip could be used indefinitely while the caster has a valid target, effectively rerolling the temporary hit points until they get a favorable result; this would rival an at-will false life, or the "Fiendish Vigor" warlock invocation.

As long as the cantrip provides some form of healing, it's going to be iffy in terms of balance.

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    \$\begingroup\$ In relation to your false life comparison, there's a warlock invocation that lets you do just that. The Fiendish Vigor eldritch invocation says: "You can cast false life on yourself at will as a 1st-level spell, without expending a spell slot or material components." \$\endgroup\$ – V2Blast May 1 at 1:30

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