As the wind blows through a tall oak tree beside us, she says: “The day I found out I was pregnant, I was on my way to commit suicide. I was so fed up with trying to quit. I was so fed up with living in a tent in the woods, using a bucket. I was so fed up with losing my friends and family because I was just so ashamed.”

A pregnancy test changed her mind. She then spent time in Cook County jail for theft. Her parents, sensing an opportunity for her to get clean, refused to pay her bail money. So Karen got clean, and Abby was born inside the jail.

When I ask Abby, who wants to become a tattoo artist, if she’s ever been tempted to experiment with drugs, she says: “Nah, I’ve seen it mess with my family too much, with my dad, my mom, killing my aunt, my uncles. You know, it’s not worth it to get high for like a couple of hours.”

She continues: “There’s a lot of people are struggling, especially that our country is raising our prices, raising the prices on food and it’s causing it. A lot of mental health now is very expensive so people can’t get help, and one way they can turn to that is by drugs.”

Generations of Americans have endured the drugs crisis, but it is never the same crisis. It has shifted from heroin, to prescription opioids to fentanyl and now to a whole new range of synthetics.

Successive administrations have fought – and lost – the war against drugs. The dealers, the suppliers, the cartels and users all adapt, always a few steps ahead of efforts to stop them.

Additional reporting by Darren Conway

If you are suffering distress or despair and need support, you could speak to a health professional, or an organisation that offers support. Details of help available in many countries can be found at Befrienders Worldwide, external.

A list of UK organisations that can help is available here.