I think there's potential for Side Effects to present a fresh take on Buckshot Roulette type games but two things come to mind that I wish I saw:
1) Taking certain pills having some visual/auditory/gameplay effects
2) Balance changes. For instance in Buckshot Roulette, a new round of shots are made when there's only one guaranteed outcome (e.g. only live rounds in the gun). When there are multiple poison pills in play, I feel cheated by the game when I successfully avoided poison but now both of us got to take it