In debut graphic novel, Arizona O'Neill explores connection between opioid overdoses and organ donation

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There is a section in Arizona O’Neill’s autobiographical debut graphic novel, Opioids and Organs, where the protagonist sees human organs and body parts everywhere she goes.

The quasi-fictional Arizona sees eyeballs in the egg cartons. Human hearts are being sold at the butcher’s counter. A shoe store has human feet on display next to the sneakers. A weed pulled out of a garden has human lungs attached to its roots.

One panel later, Arizona is shown hunched over her drawing table. Depictions of human hearts cover the wall in front of her.

It’s one of many surreal segments in Opioids & Organs, but it reflects a real personal obsession that O’Neill harboured for a decade. In 2015, her father died of a fentanyl overdose. O’Neill had been estranged from him for most of her life due to his addictions, but she was with him in the hospital when he was declared brain dead. As next of kin, she was urged by doctors to quickly sign over his organs. She chose to sign the papers and was immediately haunted by the decision. It led not only to O’Neill imagining she saw her father’s eyes in passersby on the street, but to a determination to dig deep into the history of organ donation and its modern realities, particularly the impact the opioid crisis and the increase in overdoses have had on boosting the supply of young organs available for transplant.

Opioids & Organs has been out for six months now. O’Neill, who will be at Wordfest’s Imaginarium on Saturday, Oct. 17 and Sunday, Oct. 18, says the obsession has faded.

“Before I had the book out, I would go on these long rants to people around me like my friends or just people I was meeting for the first time in kind of an unhealthy way, just rants about all the information I had collected throughout the years,” O’Neill says. “Now that it’s in book form, it feels like I have an object that is speaking for me out in the world and I don’t have to take on that responsibility.”

“The project took so much labour — any graphic novelist will tell you that the graphic novel is such a labour of love — it took so many years to put together that I did really get it out all on the page. Recently, people have been asking me if I will do any other artwork on organ donation. I will be very shocked if I ever touch organs again. I really got that out of my system.”

O’Neill is the daughter of Canlit royalty Heather O’Neill, who urged her daughter to begin drawing to keep her occupied while she penned her 2006 debut novel, Lullabies for Little Criminals. Her comics have appeared in various publications. She illustrated Nelly Arcan’s L’ enfant dans le miroir and collaborated with her mother on 2025’s Valentine in Montreal.

In Opioids & Organs, fictional Arizona’s journey has her accompanied by an acerbic lizard and Frankenstein’s monster. It’s lushly illustrated, touching and often funny, but it also raises questions about the organ donation industry that rarely get asked. O’Neill’s guilt and anger about her father and obsession over organ donation began immediately after his death, but it wasn’t until 2020 when she saw it as part of a bigger story. When the opioid crisis swelled during lockdowns and overdoses increased, her first thought was “that’s a lot of organs.” She discovered that research had been done on the relationship between opioid use and organ donation. She found 2018 articles that clearly made the link.

“Those articles really didn’t cause any stir at all; they didn’t even make it into my news cycle,” she says. “The information is out there, but headlines are so easy to overlook, especially when it’s something so dark and shocking. It’s a statement that nobody really knows how to deal with. If you read a headline that says there is a surplus of organs available from the opioid crisis, it’s very easy to move immediately past it. With my book, and this is why I love the graphic novel genre so much, I really wanted to make a project that made this information digestible.”

It’s not an expose, as some people have suggested, because this information had already been exposed, she says. “I was just bringing humanity to it.”

In the novel,  Arizona goes back in time to when grave robbers dug up corpses and stole organs for medical research, and scientists conducted cruel experiments on animals. She visits the organs and cadavers on display at the Maude Abbott Medical Museum at McGill University, and the skull-and-bones-filled catacombs of Paris. O’Neill visited these places in real life, which led to mountains of research she acquired over the decade. While some critics have said the book is an indictment of the system, O’Neill sees it more as an invitation to view organ donation and its relationship to some of society’s most vulnerable with more nuance.

“Going into the project, I wasn’t so cynical that I thought organ donation shouldn’t exist; it saves lives and is an important science for many people,” she says. “I did start to do a lot of research on both sides and realized there was a lot of silence around the negatives of it. I thought the silence was weird, and I saw the connection between the way we don’t speak about addiction and the way we don’t speak about issues with the organ trade was quite similar. The silence around addiction is what always got me; even as a teenager, it always upset me. When I saw the silence around both those topics, I wanted to remove it.”

Like her main character, O’Neill’s views evolved. She was overwhelmed with anger and guilt when thinking about organ donation, but as the project continued over the years, she saw it less as that and more about addiction and creating empathy for addicts. People would often tell her during the process that they didn’t realize healthy organs could come from drug addicts. They assumed they were damaged goods.

“My issue was not that we were benefiting from an addict’s death but that we were not even acknowledging it,” she says. “This lack of acknowledgement was really upsetting to me.”

“I think a lot of people, before they read the book, think that the book is going to be anti-organ donation,” she adds. “That’s really not what the takeaway is once you read (it). Sometimes people will confront me with it, but they haven’t read it. People who have read the book never confront me with that… I don’t want that to be people’s view of the book. There are a lot deeper things going on than the critique of organ donation.”

Arizona O’Neill will participate in The Kris Demeanor and Deborah Willis Variety Show on Oct. 17 at 3 p.m. at the DJD Dance Centre and The Dead Dad’s Club on Oct. 18 at 1 p.m. at the Memorial Park Library as part of Wordfest.