The methamphetamine problem in the Four States affects not only those who use it, it takes a toll on the most innocent victims as well.
According to doctor's at Freeman Hospital in Joplin babies are being born exposed to meth more than any other substance, including alcohol.
This can lead to developmental disabilities later in life, including ADHD, learning disabilities, or more severe effects such as mental and physical retardation.
"When women come in they are very ashamed," says Deeanne Roush, a registered nurse with the Lafayette House in Joplin, Missouri. "They may have lost their children - they have a lot of guilt. If mothers don't have enough guilt already, mothers who maybe aren't using, add an addiction and you have a woman who is so filled with guilt, shame and remorse."
Roush treats addicted mothers and says they never intentionally wanted to cause harm to their children.
"We don't tell them 'what a horrible thing - you were pregnant and using meth'", Roush says. "I think it when they're out there, but when they come here, they're asking for our help and I'm happy to give it."
When Felicity Roland, 32 of Joplin, checked in to the Lafayette House, she was pregnant, addicted to meth, and welcomed with open arms.
Roland began using meth when she was 16-years old. She says a rough childhood led her to the drugs.
"I was raised up in a really abusive, physical, mental household," says Roland. "I was sexually abused and things like that. My parents weren't the best parents and I was in and out of DVS custody."
It was an all too familiar situation when her own children were taken away from her. Not wanting to repeat the cycle Felicity sought help.
When Felicity entered rehab she was eight months pregnant and already had six children, ages two to 13. She admits to using meth intravenously every single day during all of her pregnancies except for one.
"It's a sick and cunning illness, it really is," says Roush, the nurse with Lafayette House. "You don't realize who all you're destroying when you're doing it. You know, not only are you hurting yourself but you're hurting everyone around you that care about you, and when you're carrying a baby you're hurting that baby too."
According to a report released in 2010 by the Missouri State Highway Patrol, the state of Missouri is the meth capital of the country, leading the nation for the 10th year in a row with more than 1,600 meth lab incidents.
"It's a cheap drug - it's available," says Roush. "Especially the southwest region of Missouri - we are a hot spot of meth."
Not only is it cheap and readily available, Roush says "meth addiction is so strong that even a woman carrying a baby doesn't think about her baby. She doesn't think about eating. She doesn't think about sleeping. She just wants that medication. She just wants that methamphetamine."
That was the case for another 32-year old Joplin mother of four who agreed to be interviewed as long as we didn't reveal her identity - we'll call her Christina.
We interviewed Christina five days before she was to give birth to her fourth child. She says by the time she found out she was pregnant she was completely consumed by meth and used until she was seven months pregnant.
"Because the addiction had a grasp on me, you know, that lifestyle and that - feeding that addiction to me was more important than getting clean to have a healthy baby," Christina says.
"When mom uses, baby is using, so if mom's pulse rate is racing at 130, chances are baby is racing and galloping at a rate much higher than that," says Roush. "The risk of placental rupture is very high due to meth use."
Roush says that could lead to death for both the mother and the baby.
Roland has been clean for more than three months. She says the guilt and shame of using while pregnant is a struggle she will face everyday.
"Meth makes me hate, and I hate meth - I hate meth," Roland says. "I have a lot of regrets and if I could go back and change things and do them differently I sure would."
We tried to contact Christina for a follow up-interview but she never got back to us.
Meet Hannah - age 7
For seven year old Hannah a communication board and some sign language is the only way she can communicate to the world. She is unable to talk, unable to eat on her own and unable to do practically anything for herself.
Doctors and family say it is a miracle Hannah is alive at all.
"She was in pretty bad shape," says Hope, Hannah's adoptive mother. "To me, I mean it's a miracle. It's a miracle that somebody that little with that many drugs, and meth of course being the biggie, that she survived."
Hannah's birth mother used meth while pregnant. When she was born she weighed one pound three ounces.
"She had to be resuscitated to even survive a few times," Hope says.
Doctors at Freeman Hospital say Hannah was on medication for withdrawal for seven months. They say babies born in Southwest Missouri are found with meth in their system far more often than any other drug.
"Babies can have acute intoxication events, they can have withdraw symptoms from any drug exposure," says Amanda Webb, M.D. "Methamphetamine is similar to cocaine in the fact that you can have a lot of irritability of the child, a new infant. Tremors, seizures, very increased startle responses, and that can take many weeks to go away."
Because Hannah was born premature she was in intensive care for 10 months.
Hope adopted Hannah when she was a year and half old.
Today, Hannah is seven, but her adoptive mother says her mentality is more like that of a two-year old.
"It's like her system is so scattered, she can't pull herself together," Hope says.
"These are critical times where you know you're getting major organs," says Dr. Webb. "These drugs are directly neurotoxic to the brain and they also affect neurotransmitters, and when you're affecting those types of things some of the cells in the developing brain don't go where they're supposed to or their connections are just wired differently, so you know you're going to have a child that now is forever wired differently."
Hannah's neurologist has diagnosed her as severely autistic. Experts say this could be a direct result of meth over-stimulating the fetus.
"She spends a lot of her time and energy seeking sensory input, that's the rocking and she wants you to put, you know, like her feet really hard and she gets calmed down from squeezing her because she can't get enough input," says Hope.
Due to chronic lung failure as a baby Hannah has to undergo a breathing treatment every day, and will likely need the treatment every day for the rest of her life.
Hope says that although meth has severely affected Hannah's life forever, she does not blame the mother.
"I wouldn't hate the mother you know," says Hope. "I would hate the meth, I guess, but I wouldn't hate the mother... And I'm sure when she took that first bit of meth she had no idea that she could not handle it and that it would go there, but it took over her life, damaged her kids."
Hope says she tries not to dwell on how Hannah's life may have been had she not been exposed, because she loves her just the way she is.
"She's just amazing, she's a very amazing child and she just absolutely delights us everyday," says Hope. "It's a miracle that she survived to have a story. I just wish that people could see that, so they know that it isn't just them that it effects. You know, a mother that's pregnant and uses can harm a child and it's the rest of their life."
Hope says the last she heard, Hannah's birth mother was still using.
If you or someone you know is suffering from a meth addiction, we want to remind you there are plenty of treatment facilities available in the Four States area to get help and all of them urge to call. For a list of resources visit our list of meth addiction treatment facilities.