can buprenorphine cause dilated pupils
The pinprick pupils are caused by mu receptor activation, and reversed (as we all know) during mu receptor antagonism or withdrawal. The pupil size is a good indicator of the subjective experience. If a person has low or no opiate tolerance, buprenorphine will cause the person to feel an opiate 'high', and will constrict the pupils. If a person is taking buprenorphine every day, appropriately, there is no high, and the pupils are not affected. If a person is using high doses of oxycodone or heroin and takes buprenorphine, the person will feel lousy, i.e.precipitated withdrawal, and the pupils will be very large.