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Fighting a battle they never chose, the most vulnerable patients slumber solemnly in the quiet corners of hospital nurseries, disadvantaged and unready for the world beyond them. Every year the opioid epidemic affects hundreds of thousands of people, and the most overlooked victims tend to be the children. Many babies exposed to opioids before birth suffer from Neonatal Abstinence Syndrome (NAS), or withdrawal after birth.
These infants cry, struggle to eat, and endure pain they cannot understand. While some recover and often appear healthy, the consequences often emerge years later in classrooms, subtle moments at home, and struggles to keep up with the fast pace of daily life. For many families, the path forward is uncertain, with nothing to guide them, creating a gap of needs and ways to meet those needs.
This is where Lenette Serlo’s journey begins. Based in Florida, she is a mother who had already adopted two daughters with drug exposures and she and her husband brought home a baby boy who had been exposed to opioids in utero.
“We didn’t understand at that time that there were going to be long-term issues associated with his opioid exposure,” Serlo recalled. “We just saw a little baby that we wanted to join in our family.”
What she soon learned was that the effects of opioid exposure are not always visible at birth.
Serlo’s awareness came a decade later when she adopted another baby with prenatal opioid exposure. By then, science and her own experience had advanced.
“This time, the world had come further… I was able to connect him with services right away, early intervention services. And it really put him on a different trajectory for his life,” Serlo said.
The ultimate realization that many parents all over the world may be facing similar problems and questions regarding caring for their child led Serlo to create the first national nonprofit dedicated to raising awareness, supporting families, and advocating for policies in systemic care for opioid exposed children.
Her nonprofit Generation O began as conversations in a Facebook support group (now a network of caregivers and adoptive and foster parents of more than 7,500) grew into a movement.
“There wasn’t a guidebook. My pediatrician didn’t know what to tell me,” Serlo said. “So the more I learned, the more passionate I became about sharing my knowledge with all the other parents out there who are raising these kids.”
This network has now become a collective base of support and awareness for children’s long-term developmental, neurological, and behavioral concerns.
The term “Generation O” is attributed to that of the children affected by the opioid epidemic; it is a term used by Serlo’s team to unify their identity and highlight the children’s often-overlooked struggles. Unlike conditions such as Down syndrome, which are widely recognized, opioid-exposed children “don’t have a long-term diagnosis; they’re not getting the services they need, [and] don’t have any outward signs showing that they have this,” Serlo asserts.
Yet their numbers are growing. In “Generation O the number of babies born opioid-exposed each year is three times higher” as stated by Serlo.
The organization now partners with researchers, policymakers, and universities to advocate for systemic change. One major push is for standardized lifelong care.
“The solution exists; we don’t have to create a new system for these infants,” Serlo explained, referring to high-risk infant programs where children are regularly monitored by teams of specialists.
Generation O is also piloting programs like ThrivePoints, which educates parents through online courses while rewarding them with developmental toys, and connecting professionals with training through initiatives like Project SCOPE.
To further their need to champion support for children, the nonprofit declared October as “National Opioid-Exposed Children’s Month”, an annual campaign to spread awareness across the country. For Serlo, it is not only about her own children, but for future mothers, parents, families, and generations to come.
“We don’t want the kids who are going to be born in 2026 and 2027 to have to go through the same circumstances that we had to,” Serlo said. “We want them to have a guidebook.”
The opioid crisis is often told through statistics and headlines about overdoses, but the stories of its youngest victims remain uncovered. Generation O seeks to change that, and Serlo is calling for others to join. Because, as she reminds us, these children are not statistics. They are our future.
To support Generation O’s mission and help create a brighter future for opioid-exposed children, consider donating.
This article was written as part of a program to educate youth and others about Alameda County’s opioid crisis, prevention and treatment options. The program is funded by the Alameda County Behavioral Health Department and the grant is administered by Three Valleys Community Foundation.
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