This is first in a MassLive special report on the the impact of the opioid crisis on children in Massachusetts.

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When Jaclyn Alexander returned to the United States from military service in Iraq, her war was just beginning.

From an airbase nicknamed "Mortaritaville," to nerve damage in her back, to oxycodone, to morphine, to addiction. From addiction, to motherhood, to theft, to heroin, to detox and dope sickness, to recovery, to the Baystate Medical Center Neonatal Intensive Care Unit, where she sat holding her second daughter, quiet and calm but born dependent on the suboxone keeping her mother from relapse.

It has been, she said, a long road.

"I could not be in a better place. If you asked me a year ago if I would be right here right now I would absolutely have said no," Alexander said, amid the soft whooshes and mechanical chirps of the medical ward. "It's a phenomenal turnaround."

Alexander's baby, Ella Donna, is one of the growing number of children born dependent on opioids - what doctors call neonatal abstinence syndrome. It is a condition that requires special care, but is treatable, with approaches that have been refined as Massachusetts' addiction crisis has given the state one of the highest rates of NAS in the country.

And like the mothers of many NAS babies, Jaclyn is clean - and has been for a year. Dr. Rachana Singh, the head of Baystates' NICU, said that doctors advise mothers to enter medically assisted treatment programs and not cut heroin cold turkey, to ensure the highest chance of recovery and keep the baby stable.

While the use of medically prescribed opioids to kick heroin provides the best outcomes for babies, Singh said, it does mean that those children are born exposed to opioids - which, in about 40 percent of cases, leads to withdrawal and neonatal abstinence syndrome.

Ella Donna is a "trooper," her mother said, without the fussiness that many other NAS babies experience as a symptom. But though Alexander is proud of the life she has stitched back together, and is following her doctor's advice, her daughter's dependency still weighs on her.

"It's one thing to put yourself through it. It's heartwrenching to put a child through it," Alexander said. "You do have a lot of blame and guilt on yourself - could I have been tougher? Was I too weak?"

Alexander's path to and from the brink took her from Western Mass., across the globe and back again.

Alexander, 31, grew up in Palmer. After high school she worked at an Italian restaurant in Wilbraham, but soon felt hemmed in by her life there and its limited ambitions.

She decided to join the Army in 2007.

"I think I was just tired of working nonstop. I didn't have health insurance. I kind of wanted to go to school," Alexander said. "I wanted to get out of a small town and do something with my life, do something that could make everybody proud."

She was already experiencing some back pain by the time her unit deployed to Iraq in 2008, but it was not severe and she did not want to be left behind. She would spend 13 months working on Balad Air Base north of Baghdad - a hot zone that soldiers took to calling "Mortaritaville."

"We were mortared on a daily basis," Alexander said. "It was a pretty big target. You kind of get used to it after dealing with it every day."

The pain in her back got worse. When she was redeployed to the United States in 2009, she received an MRI and was diagnosed with nerve impingements and herniated disks.

She was stationed in Savannah, Georgia, and began receiving pain management from an off-base civilian doctor.

The solution the doctor prescribed was opioids, in heavy doses. At her peak, Alexander was taking 120 mg of oxycodone per day, including "breakthrough" doses designed to control the pain as her long-acting pills wore off.

"Looking back now I was massively overprescribed," she said. "You build up such a tolerance to oxycodone that you have to keep increasing, keep increasing."

By 2011, she knew she was addicted. She had begun snorting pills and finding extras when she ran out at the end of the month. Neither the military nor her doctor knew she had a problem, she said.

When she moved back to Massachusetts in 2012, she began seeing a Veterans Adminsitration doctor who prescribed her lower doses. But Alexander made up the difference by buying off the street, and continued using after receiving a medical discharge in 2013.

She had a daughter, Lana, while on medically prescribed morphine for her back. She tried to wean off the drug while pregnant, but the baby's heartrate spiked and Alexander began feeling withdrawal sickness, so her doctor advised her to stay on the painkillers.

Lana was born dependent and spent time in the NICU for withdrawal symptoms.

And then, when Lana was 6 months old, Alexander began snorting heroin. It was a financial decision; heroin was about 10 times cheaper per dose than oxycodone.

Her addiction began fraying her relationship with her family.

"I had significantly taken advantage of a lot of people in my life. Stolen a lot of money from my grandmother. Morally done things that were beyond anything I would ever do," Alexander said. "It was not who I am."

Her daughter's father, who was also addicted, moved to Florida, and Alexander had a realization: she was all her daughter had. She knew she had to get clean, she said.

"If something happens to me, what's going to happen to her? I couldn't shake that," she said.

Lana's second birthday was coming up, and Alexander called her father: she wanted to start detox the day after. Her father dropped her off at the VA in Northampton and she entered treatment, which began with days of withdrawal - no drugs, and consuming, shaking sickness.

It was a reminder of the cost of relapse, Alexander said. She began medically assisted addiction treatment and has not used again since; she was a year clean as of Nov. 29, she said.

Her life began turning around. Her treatment program was "amazing and supportive." She began going to support groups. And she met Matt, a fellow veteran in treatment at the VA. They began dating; he became a father figure to Lana, she became pregnant again, and they got engaged.

Ella Donna was born in December, and entered treatment at the Baystate NICU for neonatal abstinence syndrome. She is on medication, similar to what her mother takes, for withdrawal symptoms.

Alexander has been here before, after Lana's birth, which she described as "emotionally traumatic." Having her daughter taken away from her, and the fears that her condition was worse than doctors were letting on; Lana's distress as she was weaned off opioids.

Ella Donna is doing better than her sister; she is a "tough cookie," a "champ," Alexander said. And despite the struggle, the judgment and the long path to recovery, Alexander said she is grateful for where she and her daughters have ended up.

"I don't have any shame in it," Alexander said. "I could be in a lot worse place."