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Study breakdown

Pupil Response Changes Could Help Detect Recent Cannabis Use

ObservationalModerate evidence
The takeaway

Objective pupillometer measurements showed diminished pupil dynamics (how pupils respond to light) were more predictive of recent cannabis use than pupil size alone, with moderate accuracy at 40 and 100 minutes post-use.

Traffic safety researchers, forensic toxicologists, law enforcement, drug testing researchers

Pupil dynamics predicted recent cannabis use with moderate accuracy (AUC 0.73-0.75)

What the researchers found

The most predictive pupillary measure was percent change in pupil size, which decreased after cannabis use, with an area under the curve of 0.73 at 40 minutes and 0.75 at 100 minutes. Pupil size alone (measured in darkness) did not reliably change after cannabis use. Diminished pupil dynamics (constriction to light and recovery dilation) were more predictive than static pupil size.

Why it matters

Law enforcement currently relies on subjective assessment of eye changes during drug recognition evaluations. This study tested whether objective pupillometer measurements could improve detection accuracy, finding moderate but imperfect predictive value.

The numbers in context

126 participants; AUC 0.73 at 40 min and 0.75 at 100 min for percent change in pupil size; maximum pupil size in darkness not reliably changed; diminished constriction and recovery dilation more predictive; combining multiple measures did not meaningfully improve prediction

How the study worked

126 participants assessed with a NeurOptics PLR-3000 pupillometer at baseline and at 40 and 100 minutes after ad libitum cannabis inhalation (95 cannabis users, 31 controls). Sensitivity, specificity, and accuracy calculated for multiple pupillary measures.

What this study cannot tell us

Moderate predictive accuracy (AUC 0.73-0.75) means significant false positive and negative rates, participants used their own cannabis products creating dosing variability, pupil dynamics can be affected by other substances and medical conditions, laboratory conditions differ from roadside testing

How to read the evidence

Well-designed controlled study with objective measurements; moderate accuracy limits practical standalone application

When this study was published

Published 2025

The bigger picture

The search for reliable, objective markers of recent cannabis use continues to challenge both researchers and policymakers. Pupillary dynamics show promise but cannot yet serve as a standalone test, suggesting they might work best as part of a multi-measure assessment.

Questions still open

  • Could pupillometry combined with other objective measures (balance, cognitive tests) improve detection accuracy? How do different cannabis products affect pupillary dynamics? Would the test perform differently in naive vs. tolerant users?

Common questions

Can a pupil test tell if someone recently used cannabis?
With moderate accuracy. Changes in how the pupil responds to light (not its resting size) were the best predictor, correctly identifying recent cannabis use about 73-75% of the time.
Why not just measure pupil size?
Cannabis did not reliably change maximum pupil size in darkness. Instead, it was the dynamic response (how pupils constrict and recover after light exposure) that was altered, likely reflecting cannabis effects on autonomic nervous system function.

Read the original research

Pupillary dynamics as a marker of acute cannabis inhalation.

Clinical toxicology (Philadelphia, Pa.), 63(11), 869-877

Citation

Brooks-Russell, Ashley; Godbole, Suneeta; Kosnett, Michael J; Limbacher, Sarah; Subramanian, Prem S; Brown, Timothy; Wrobel, Julia. (2025). Pupillary dynamics as a marker of acute cannabis inhalation.. Clinical toxicology (Philadelphia, Pa.), 63(11), 869-877. https://doi.org/10.1080/15563650.2025.2543066