Final answer:
Tolerance to opioids does not typically develop for miosis (pupil constriction) and constipation. These effects persist even when other effects require higher doses for the same intensity. Tolerance means needing more medication for the same effect, except for these two persistent opioid effects.
Step-by-step explanation:
Tolerance to opioid effects occurs to all but miosis and constipation. Thus, the correct answer is a) Miosis and constipation. Tolerance is defined as a phenomenon that occurs when a drug user requires more and more of a given drug in order to experience the same effects. This means you might need to take more of the medication for the same pain relief. However, tolerance does not typically develop to the opioid effects of miosis (constriction of the pupils) and constipation. These two effects tend to persist even as other effects, such as analgesia, euphoria, and sedation, require higher doses to achieve the same level of intensity.
Opioids act as both analgesic and narcotic substances. In low doses, they reduce pain without loss of consciousness (analgesic effect), and in higher doses, they can induce drowsiness and loss of consciousness (narcotic effect). Opioids are also used in cough suppressants, anti-nausea, and anti-diarrhea medications.
While physical dependence is a concern with opioid use, resulting in withdrawal symptoms when the medication is stopped, it is tolerance that necessitates escalating doses to achieve the same level of pain relief or euphoria. Notably, opioid-induced constipation and miosis are two effects to which users usually do not develop tolerance.