strabismus and recreational drug use

we noted a friend with bilateral pinpoint pupils and periodic strabismus of both eyes, but at separate times.  could this be a side effect of heroin or oxycodone use?  are there other known causes that would be seen in a 24 y/o known drug abuser?
rocky540

[John C Hagan III, MD, FACS, FAAO]

Yes. Yes.  Well there would be strokes, intracranial bleeds, talc or other adulterant embolization, still other illegal and deadly drugs.

"Recreational" drugs. What a euphanism and cop out.

JCH III MD

[rocky540]

I'm aware that those are also known causes, but we were eating dinner and though he was "slow to process", there were no other associated symptoms. when confronted he blamed "coming off lexapro", but i am rather skeptical.

Indeed, the use of "recreational" with drugs, is in fact a cop out, but not mine;  it's rampant in the literature.  this man is a know drug abuser and addict.  i'd never seen him like this and, though i've since run into some clinical literature that associates strabismus with heroin withdrawal, i just wondered about it.  it was a very strange evening.