Mitragynine in the Orange County DUID population.

This article focuses on the detection and evaluation of mitragynine and its metabolite 7-hydroxymitragynine (7-OHM) in driving under the influence of drug (DUID) cases in Orange County, California, from 2017 to 2019. Among 25,398 DUID cases, 60 (0.24%) had mitragynine detected, predominantly in white males around 32 years old, with no cases involving mitragynine alone; poly-drug use was common, especially with central nervous system depressants, stimulants, and opioids. Field sobriety tests (FST) and Drug Recognition Expert (DRE) evaluations indicated impairment but could not isolate mitragynine's specific effects due to co-occurring substances. The study highlights the importance of comprehensive toxicological screening, including advanced liquid chromatography–quadrupole time-of-flight (LC–QTOF) methods, for detecting mitragynine and improving DUID case interpretation.