An “intelligent and successful” Wigan mother, whose life fell apart following the kidnap of her daughter, has died from the effects of prescription medication, an inquest has heard.
Nichola Smith from Harlech Street in Ashton was 39 years old when she died on July 15 after taking a “cocktail” of medication for pain relief, anxiety and depression.
The inquest, held at Bolton Coroner’s Court, heard of Ms Smith’s quick rise to success within the dental industry following a move to Dubai more than 15 years ago and the “harrowing timeline” of events which led to her untimely death.
Coroner Timothy Brennand spoke to Ms Smith’s father Cyril Smith who unravelled the series of tragic events which rendered his daughter in “constant pain” both mentally and physically.
The court heard how Nichola, once moving to Dubai, worked her way up to senior dental nurse, head of department and head of health and safety at a dental hospital.
It was shortly after this, in 2002, when she met her husband, only referred to as “Ahmed”, when her troubles began.
Mr Brennand said: “I think her husband was someone who brought a real sadness into her life prior to the divorce.”
The family’s statement explained how Ms Smith suffered a number of “serious assaults” at the hands of her husband, putting her in hospital and permanently damaging her back resulting in a lifetime of pain which was managed with prescription medication.
Shortly after the divorce Ms Smith sent her daughter for a routine visitation with her dad, who kidnapped her and took her back to Jordan.
Mr Smith told the court: “We won all the court cases in the Emirates and all of the cases in Jordan and we still couldn’t get her back. It was devastating.”
It was following this that Ms Smith’s life began to “spiral out of control”, and after her return to the UK in 2015 she began taking numerous medications to combat back pain, pain caused by stomach ulcers and anxiety and depression.
“Self-medication was a real problem to her,” said Mr Brennand. “She was addicted to pain relieving medication.”
Mr Brennand heard evidence from mental health professionals to quickly establish that the former dental nurse did not die as a result of suicide, but as a result of the effect of numerous pain killers on her respiratory system.
A post-mortem examination revealed that Ms Smith’s liver had incurred a “change” which is a possible side-effect of medication taken over a long period of time. The report also listed respiratory failure brought on by the combination of medicines.
Tracey Myton, specialist in addiction therapy for Greater Manchester Mental Health, told the court that she prescribed “methadone” a strong opioid often given to heroin addicts, to help Ms Smith with the pain.
But Ms Myton confirmed to the coroner that she ordered Ms Smith’s GP to stop all other medications, of which there were three more opioids.
Mr Smith told Mr Brennand how it is possible that despite this, his daughter may have “stockpiled” the cancelled medication, meaning that she could have continued to take it as her methadone prescription was increased.
The court heard how on the day of her death, July 15, Ms Smith was supposed to be on a shopping trip with her family who she saw almost every day. Mr Smith told the coroner how he had knocked on the door of his daughter’s Harlech Street home and heard her dog bark inside.
When he failed to gain a response he assumed that Ms Smith was having a lie-in and left to return later.
On his second visit, when Mr Smith tried to get a response and failed again, he went around the back of the house where he could see Ms Smith lying on her side on the bed. He climbed through the window and discovered that she was “cold to the touch” before calling paramedics who pronounced her dead on arrival.
In a toxicology report, a “potentially lethal” dose of methadone was found in Ms Smith’s blood as well as opioids including Tramadol and Fentanyl as well as relaxant Amitriptyline,
Paracetamol and Ibruprofen. Ms Smith had been advised to take no other medication while on the Methadone prescription.
However due to the lack of evidence presented as to when the medication was taken prior to her death, Mr Brennand was unable produce a conclusion of “accidental death” or “misadventure”,
Instead he told the family that Ms Smith likely died as a result of the respiratory failure brought on by the cocktail of medication she was taking prior to her death, although it could not be determined when a fatal dose was taken.