Our Statement on MOUD

Generation O recognizes that some prenatal opioid exposure occurs in the context of medically recommended treatment, including medications for opioid use disorder (MOUD) such as methadone and buprenorphine.

Current clinical guidance supports MOUD as the standard of care for pregnant individuals with opioid use disorder, as it improves maternal stability and reduces the risks associated with untreated opioid use.

At the same time, emerging research indicates that prenatal opioid exposure—including exposure to prescribed medications such as methadone and buprenorphine—may influence early brain development. Recent studies have identified measurable differences in newborn brain structure, including smaller global and regional brain volumes at birth.¹ ² These findings are still evolving and do not establish long-term outcomes on their own, but they underscore the importance of fully informed, individualized decision-making during pregnancy.

Generation O does not provide clinical guidance on treatment decisions. We believe:

  • Pregnant patients should receive clear, balanced, and up-to-date information about both maternal and infant considerations

  • Treatment decisions should be made collaboratively between patients and qualified medical providers

  • Access to care, treatment options, and provider expertise remains uneven and meaningfully shapes real-world choices

There is no one-size-fits-all solution. While tapering may be appropriate for a small subset of stable patients under close medical supervision, it is not safe or appropriate for all individuals.

Most importantly, regardless of the cause of exposure, children with prenatal opioid exposure—including those exposed in the context of MOUD—may have developmental differences that emerge over time and reflect a constellation of nervous system-related needs, not isolated diagnoses. Caregivers often report challenges across areas such as regulation, sensory processing, sleep, feeding, and learning—patterns increasingly reflected in emerging research and real-world experience.

Generation O’s role is to ensure that caregivers are equipped with the knowledge and practical tools to support these children as they grow.

References

  1. Wu Y, Merhar SL, Bann CM, et al. Antenatal Opioid Exposure and Global and Regional Brain Volumes in Newborns. JAMA Pediatrics. 2025;179(6):639–646. doi:10.1001/jamapediatrics.2025.0277

  2. Madurai NK, Jantzie LL. Following the Developing Brain Affected by Opioid Exposure. JAMA Pediatrics. 2025;179(6):596–598. doi:10.1001/jamapediatrics.2025.0274