I feel like this game's item play is much more aggressive than other Mario Karts. And getting hit can mean you lose 1st for the race. High level play is so cutthroat.
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For instance, the fire flower gives you a long ranged option than can stun lock others. Because it's a smaller stun, you can get locked down and lose all of your coins. And it's an item you get in like 3rd or 4th. Arguably better than triple reds almost.