Why some people experience no side effects from a drug?
NOTE: Please, do not refer to the article it has been given as an arbitrary introduction to the question
I've stumbled upon an article daily heroin usage for 20 years.
Basically, the article is describing a successful businessman who had been taking heroin multiple times a day for 20 years and had no side effects.
This is just an example of what I'm trying to ask.
My question is: Why do some people react badly to some drugs/medication while others take them like candies with no side effects?
Is it just genetics in action for some people which prevent reactions in our body or is it something else?
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One of the major things about heroin is that it is metabolized by the body as morphine and, if this person in the throes of heroin withdrawal were given medication like methadone, it couldn't be done without medical supervision as these are both really powerful drugs. Did the article say anything about the patient's daily ANYTHING?
With the assistance of doctors and others they're not obligated to divulge - HIPPA, the Health Information and Patient Protection Act would prevent the magazine from posting without express permission from the subject written about, and by 'subject', I mean the patient, not the point of the article.
That said, everyone has a different constitution regarding narcotics and other drugs. For some, the first exposure is deadly (chloroform, for example), others can handle much bigger exposure to multiple drugs because their constitution has been 'amped up', let's say, by usage of other drugs that we know nothing about, especially since no one can force a patient to be completely honest about their drug intake for any reason, nor is it a good idea to take someone else's word at the drop of a hat because people can simply write down their lies.
It's entirely possible that the businessman experiences withdrawal symptoms that are very well hidden by other drug use, or sedatives like the aforementioned methadone, especially if the patient is as heavy a user as you state.
Most drugs have wanted (main) and unwanted (side) effects, but neither of them are guaranteed. For example, aspirin may or may not relieve your headache and may or may not upset your stomach.
The lists of drug side effects base on decades of studies and consumers' reports, such as FDA (US), YellowCard (UK), Adreports (EU) and Medsafe (NZ), but if, let's say, ibuprofen has 100+ reported side effects, you as a single user will likely experience only few, if any.
The differences in side effects can depend on:
1. Drug factors:
Chemical form: Supplemental carbonyl iron can have less side effects that iron sulfate.
Physical form: Capsules may upset your gut less than tablets.
Administration: Iron by mouth can cause severe stomach irritation, while intravenous iron usually does not.
Taking certain foods (aged cheeses, sauerkraut...) along with the antidepressants called MAO inhibitors can severely increase your blood pressure.
Not taking enough water and dietary fiber can cause severe constipation when taking certain drugs, such as calcium, opiates, antihistamines or antidepressants....
Toxicity of statins can make you gradually intolerant to them.
Adulteration of heroin or cocaine with fentanyl can have life-threatening effects.
2. Personal factors:
Genetics (body size, high threshold for side effects) can greatly affect your susceptibility for side effects.
Developed tolerance (metabolic or behavioral) to alcohol, cocaine, heroin, morphine or marijuana can greatly decrease their adverse effects (Drug Abuse).
Empty stomach is often more prone for irritation by a drug.
The social atmosphere in which the drug, such as alcohol or ecstasy, is taken can significantly influence side effects.
Initial psychological state in which one takes a drug: if worried, alcohol may make you more worried; if relaxed, it will likely make you more relaxed.
Allergy to a drug
Liver or kidney disease can slow down the breakdown of a drug and increase its side/effects.
Drug-disease reactions: Aspirin given to children with a viral infection, such as chickenpox or flu, can cause a fatal damage of the liver and brain (Reye's syndrome).
The bottom line: A side effect is not necessary an inherent property of a drug.
Bonus: Side effects, interactions and contraindications of medications, supplements and herbs (MedlinePlus, Mayo Clinic, Drugs.com, DailyMed)
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