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The apparent overdose death of a 10-year-old girl who accidentally ingested methadone on Minneapolis' South Side last month has put new focus on the city's growing opioid epidemic.

The Nov. 21 episode was another annotation to the city's grim tally of overdoses from opioids and other drugs — as of Monday, Minneapolis had logged a decade-high 1,416 overdoses, 78 of which were fatal, according to police records.

On the day of the incident, emergency personnel were dispatched at 2:30 a.m. to a home in the 3900 block of S. 46th Avenue for a report of a young girl who was choking.

The girl was found not breathing and without a pulse in a second-story bedroom, according to a fire department report. She had "an [excessive] amount of vomit in the airway," the report said. Firefighters and paramedics tried to revive her using CPR and an automated external defibrillator, but she was pronounced dead after being rushed by ambulance to HCMC.

The report didn't say whether the girl lived at the residence or whether anyone else was home at the time of the incident. While no cause of death has been officially released by the Hennepin County Medical Examiner's Office, a police report says that she died of an overdose.

A preliminary police investigation determined that a family member, who is a recovering heroin addict and had recently relapsed, accidentally gave the girl methadone instead of an over-the-counter medication. Her death was one of four lethal overdoses that week.

The case was later assigned to a homicide detective, as many fatal overdoses now are, but police officials have otherwise declined to release details about the incident. On Thursday, a department spokesman said that he couldn't comment on the matter because the case has been turned over to the county attorney's office.

A spokeswoman for the office confirmed Thursday that the case was being reviewed for possible criminal charges.

Methadone, experts say, is one of the few proven treatments for opioid addiction, but at the same time it is addictive and dangerous in its own right and therefore strictly regulated.

According to Charles Hilger, executive director of Specialized Treatment Services, the drug used to wean addicts off heroin and prescription painkillers has acquired a bad reputation after a series of high-profile overdoses around the country.

"There's then a risk that's been pointed out over the years, because kids can think it's Kool-Aid, and it's this and it's that, and then consume it," said Hilger, who runs three treatment clinics in St. Paul and Minneapolis. "[But] to the best of my knowledge, this is the first case that I've heard of a child overdosing or poisoning over methadone."

While rates of methamphetamine and cocaine abuse are soaring, heroin and prescription opioids are still the No. 1 killer on city streets, city officials say. In particular, they have noticed a rise in fentanyl-laced fake oxycodone pills being sold in recent months.

Data from the medical examiner's office show that 253 people died of drug or alcohol abuse in the county through the first 10 months of the year. The presence of fentanyl, the highly addictive synthetic opioid that is many times more potent than heroin, was detected in at least 113 of the cases, the data show.

The average age of victims was 43, but officials say younger users are increasingly in the mix. The death of the south Minneapolis girl, whose identity has not been released, was at least the 13th fatal overdose so far this year involving victims 21 and younger.

In another case, a 13-year-old boy died at Children's Hospital earlier this year after overdosing on a combination of drugs in what medical examiners later ruled was a suicide.

Methadone is usually given in 10- to 30-milligram doses — a potentially lethal amount for a child, according to Stephanie Devich, a harm reduction specialist at Valhalla Place, a treatment center in Brooklyn Park.

"The average person, depending on what amount it was, it probably wouldn't do much of anything, but a 10-year-old is much smaller and has a faster metabolism," Devich said.

Through Oct. 31, at least 16 people have died of overdoses involving methadone in the county, although the number of such cases has been trending downward over the past few years, county records show.

In Minneapolis, the overall number of overdoses, both fatal and nonfatal, this year have easily surpassed the 954 overdoses reported in all of 2018, leaving city and public health officials scrambling to respond.

While the number of nonfatal overdoses is up significantly in Minneapolis this year, drug deaths have decreased. Minneapolis totaled 97 fatal overdoses last year, almost triple the 34 it had in 1999, according to Health Department data. Drug deaths peaked with 117 in 2017.

This mirrored a national trend that saw overall drug deaths fall 5% from 2017 to 2018, the first significant decline since the 1990s. There were 331 opioid overdose deaths statewide last year.

Libor Jany • 612-673-4064 Twitter: @StribJany