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Since I am not a clinical pharmacologist I can’t dispute what you are saying .. The problem isnt the stomach for me it is the liver enzymes.

This article lays out the mechanics of OXY

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704133/

So for me, I have no CYP2d6 and some variants in CYP3a4 that are in the ‘emerging’ category of clinical study. But what is interesting is that your post made me look up that article and in that article it talks about uridine diphosphate glucuronosyltransferase (UGT) for metabolism. There are several genes related to that so I pulled up my Nebula DNA.

Sure enough, I have a red flag in one of them that when you look it up it mentions tramadol. So this requires me to do more research into the rest of the genes and variants related to UGT and pain relievers

But I will give the under the tongue thing a try just to see what happens.

so for anyone that happens on this thread and you dont know what the heck I am talking about in respect to drugs read this article.
https://www.ncbi.nlm.nih.gov/books/NBK100662/

And this would apply to other drugs and other enzymes.

So For example, I am a poor metabolizer of Codeine. I have been given it before and it didnt do anything for me. Of course all I got from the Doctor was different people react differently to drugs. But how many times do I have to go through this before someone thinks..Oh wait...you might have a gene problem

On the other hand, an Ultra metabolizer would get the pain relief but might have side effects that are similar to overdosing.

And this doesnt even cover the drug/drug interactions.

It is a very very complicated topic. You really need to consult with a clinical pharmacologist because the average Doctor isn’t going to know what the heck to do with this. They likely will have heard of it in med school but have no practical knowledge on how to deal with it.

And they certainly don’t think to test you for it. Instead, just say meds react in different ways for different people...”let’s try another”