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Drugs can cause a pupil to change in two ways by dilation making the pupil larger or constricting the pupils.â¦ Only two drugs constrict the pupils those being opiates and alcohol. So anything but, these can cause the pupils to dilate.
It's important to remember that not all drugs will produce the same degree of pupil dilation. For example, MDMA will have a much more profound effect on pupil dilation than, say, an antidepressant. And interestingly, other drugs, like opiates, cause the opposite effect â pupil contraction, or what's known as miosis.