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"Sure, go for it" sure sounds like the next Opioid epidemic.

Metformin is fairly safe as far as pharma goes; it requires a high dosage to be toxic, and the primary side effect is gastrointestinal distress. It's also a cheap generic (~5 cents/pill, costs me $2/month). It would be unfair to lump it in with the opioid epidemic, considering the differences.

Would you not at least try to live a bit longer for only $25/year and a once a day pill?

Berberine is OTC. Not sure what relative risk profiles are. But yes, it's absolutely not comparable to opioids.

It seems Berberine and Metformin have different activation paths (Berberine might not lead to AMPK activation) and don't necessarily have exactly the same effects. Is there any research on the two being comparable for longevity purposes (other than lowering tumor risk)?

https://lifespanbook.com/metformin-pill/

Oh, I already have IBS, so that's a hard pass for me.

Doesn't happen to everyone, and if does occur, it usually subsides after a week, but I would not recommend to someone who has IBS.

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