Let’s say it together: Requiem for a Dream got it wrong. This film, made by the director of Black Swan, is a pretty intense tragedy about heroin and amphetamine addicts. Although its harrowed portrayal of drug use is disturbing (and accurate), the director’s film adaptation of the novel casts light on his ignorance about how heroin affects pupillary physiology.

Narcotics Hijack the Human Pupil

Pupillary physiology? Sounds like some boring science crap no one cares about. But the human eye is actually pretty interesting. Eyes are windows to the soul, right? They’re also windows to the drugs floating around your bloodstream. Physiology is a fancy word for normal bodily functions, and narcotics are champions in changing how your pupils behave. The biology is pretty complex, so we’ve laid out a comprehensive list of how common controlled substances hijack your eyes differently (and how Requiem got it wrong).

2 Ways Drugs Hijack the Pupil

Change #1

Large Pupil: Oh My(driasis!)

Ever gotten your pupils dilated? This is known as mydriasis. Your pupils get HUGE. Blown pupils are the result of blocked nerve receptors. Ever heard of serotonin? Those little guys are chemicals that are regulated by the brain and control mood levels. Huge floods of serotonin cripple the eye nerves that control when your pupils constrict. Dilation naturally follows. Narcotic drugs that cause dilation are:

  • Amphetamine
  • Cocaine
  • Methamphetamine
  • Ecstasy/Molly/MDMAs
  • Marijuana

Serotonin is not the only guilty party. Dopamine (another chemical increased by some narcotics) excites your body’s adrenergic receptors. This is why drugs like cocaine and amphetamines increase adrenaline levels; the resulting “fight-or-flight” response also increases heart rate and mobilizes bodily energy.

Change #2

Small Pupil: Miosis Neurosis

This is what is known as “pinpoint” pupils. Miosis is the constriction of pupils into tiny black dots, and drugs that cause this effect are known as miotic. Wonder what those drugs are? Drumroll please…

  • Morphine
  • Opium
  • Alcohol
  • Opioids! *

Opioid narcotics stimulate the Edinger-Westphal nucleus in the midbrain. This nucleus sends signals to the eye sphincter (yes, that’s a thing) telling it to constrict. As the eye sphincter becomes tight, the pupil appears smaller and creates aforementioned “pinpoint” appearance.

* Read: Heroin.

This is where the director of Requiem got it wrong. Heroin is an opioid narcotic, meaning it causes your pupils to get smaller. One of the most iconic scenes in the film (the one that graces its poster, and has now usurped the original novel’s cover) shows Jared Leto’s character Harry getting high off heroin. His pupils are shown getting bigger rather than smaller, which is not how opioids actually affect pupillary physiology.

Interesting science aside, it’s important to remember that small details like that are a technicality. The film itself is an impressive study in how “shock & awe” can live alongside nuance in storytelling.

Be forewarned that this film’s explicit scenes of drug use can be a huge trigger for recovering addicts. It can also serve as a jarring reminder of how addiction makes your life into a train wreck, so tread with caution. New Start Detox’s case staff are experts in the psychology of triggers. No matter how trivial they may seem, we strongly recommend that you talk about those feelings in meetings and individual therapy sessions.

New Start Detox

Narcotic detox & residential care

Get Info ›