Dear Dr. SerVaas: Could you tell us about pinpointed pupils? My aunt, who is a nurse, said that my boyfriend might be on hard drugs. When I asked her why, she said it was because he had pinpoint pupils.What do pinpoint pupils have to do with addictive drugs? What addictive drugs could cause pinpoint pupils?

Dear Reader: Pupils that remain very small, or pinpoint, might suggest that a person is abusing methadone, opiates (such as heroin), codeine, morphine, or propoxyphene (Darvon).

Other addictive drugs cause the pupils to widen, or dilate. Some of these drugs include amphetamine, methamphetamine, marijuana, and cocaine.

The pupil of the eye usually reacts to bright or dark environments by changing its size. Large pupils were once considered a sign of beauty. In areas of the Mediterranean, especially around Italy, women used drops made from a poisonous plant to enlarge their pupils. Today, doctors use the drug atropine, a purified extract of the plant Atropa belladonna (beautiful woman), to dilate pupils before eye examinations and procedures.