The opioid use epidemic in the U.S. is a well-known growing problem. According to the U.S. Department of Health & Human Services, opioid use has increased nationally nearly 400% over the past 18 years¹. Subsequently, Opioid Maintenance Therapy (OMT), methadone or buprenorphine, is expanding². Additionally, methamphetamine (MA) use and abuse is a continuing problem worldwide. Rates of MA use are high In the U.S. and overseas rates are greater³. Opioid and MA use affects not only the user, but also friends, family, and the communities close to them^4,5. A child exposed to opioids, OMT, and MA in utero may have predispositions to numerous health conditions, which is also a significant impact. After an extensive PubMed search, research appears limited on illnesses, health conditions, and ongoing health related to fetal exposure to these substances. There is a lack of sufficient study on the effects of opioid, OMT, and MA use by expectant mothers on fetal and childhood health outcomes. An exhaustive database search and a retrospective epidemiological study may provide a better understanding of the health risk of children exposed to opioids, OMT, and MA in utero.