The British Journal of Psychiatry 148: 44-46 (1986)
© 1986 The Royal College of Psychiatrists
Mydriatic response to topical naloxone in opiate abusers
AH Ghodse, TH Bewley, MK Kearney and SE Smith
Naloxone hydrochloride eyedrops 1 mg/ml dilated the pupils of 36 out of 47
opiate addicts on methadone maintenance treatment, without precipitation of
acute withdrawal effects, but not those of healthy unmedicated subjects.
The response in addicts was attenuated by certain ancillary treatments and
by withdrawal of methadone treatment. The size of the response suggests
some potential clinical use for topical naloxone as a diagnostic test of
current opioid influence and possibility of physical dependence. The local
mydriatic response, which was restricted to the treated eye, indicates that
the effect of opiates on the pupil in man is determined, at least in part,
by a peripheral action.