The circumstances surrounding the death of a Palmerston woman last year, has prompted the Otago-Southland coroner to draw public attention to the importance of taking medication strictly as directed by the doctor.
Coroner David Crerar found Judith Ann Turner of Palmerston died at her home on February 3, 2012 after taking a fatal quantity of codeine, in conjunction with other prescription drugs and alcohol which had a combined central nervous system depressive effect, and had, as an outcome, her death.
Mr Crerar said an ESR investigation into her death detected codeine, used for the temporary relief of moderate pain, in her blood, at a concentration of 10mg of codeine per litre of blood.
In six cases where death was attributable to codeine toxicity alone, levels related from 0.4mg to 2.8mg per litre.
Alcohol was detected in the blood at a concentration of 156mg, about double the legal blood alcohol limit for driving.
Tramadol, prescribed and taken to treat moderate and severe pain, was detected in the blood at above levels usually associated with tramadol-related fatalities.
Zopiclone, a hypnotic and sedative used to treat transient short-term and chronic insomnia, was detected in the blood at levels above those usually associated with therapeutic use.
"Judith Turner, perhaps in a search for relief from her pain, has taken tablets, possibly failing to recognise their effects on her and possibly also forgetting that she had previously taken such tablets," Mr Crerar said.
Mrs Turner did have a history of depression. She was affected by a previous stroke and suffered from severe headaches.
Mr Crerar said she was, therefore, possibly vulnerable to suicidal thoughts, but he said she was future-focused, left no note and gave no indication of an intention to overdose.
Palmerston police Senior Constable Stefan Whitehera said on the available evidence, police were satisfied that Mrs Turner's death was as a result of an overdose of medication and do not consider there are any suspicious circumstances.
Therefore, by a slight margin, it was determined that the overdose was accidental.
Mr Crerar said the circumstances of Mrs Turner's death caused him sufficient concern to have them drawn to public attention.
He urged those taking prescription medication to strictly comply with dosage and timing and warnings given about mixing medication should be heeded.
"Those taking prescription drugs must recognise the combined effects of drugs, and the combined effects of the drugs plus alcohol, and limit their consumption of alcohol," he said.
He has recommended that a copy of the findings be forwarded to the Ministry of Health so that the Ministry considered an enhancement to existing publicity programmes drawing to public attention the dangers of taking prescribed drugs in quantities which exceed those specified in the prescription and of the mixing of drugs with alcohol.