Mitragynine in the Orange County DUID population.

Area of Science:

• Forensic Toxicology
• Drug-Impaired Driving Research

Background:

• Mitragynine, a key alkaloid in kratom, is increasingly identified in driving under the influence of drug (DUID) cases.
• Understanding mitragynine's prevalence and co-occurrence with other substances in DUID incidents is crucial for public safety.

Purpose of the Study:

• To analyze the occurrence and characteristics of mitragynine in DUID cases over a three-year period in Orange County, CA.
• To investigate the co-detection of 7-hydroxymitragynine and other drugs in mitragynine-positive DUID cases.

Main Methods:

• Retrospective analysis of 25,398 DUID cases from 2017-2019.
• Toxicological screening for mitragynine (>10 ng/mL) and 7-hydroxymitragynine.
• Review of police reports and drug recognition expert evaluations.

Main Results:

• Mitragynine was detected in 60 (0.24%) DUID cases.
• Concentrations ranged from 10.5-960 ng/mL (mean 109 ng/mL).
• Mitragynine was never detected alone; common co-occurring substances included ethanol, benzodiazepines, methamphetamine, cocaine, fentanyl, and heroin.

Conclusions:

• Mitragynine is a relevant substance in DUID cases, often part of poly-drug use.
• Further research is needed to elucidate mitragynine's specific contribution to driving impairment.