Opioids and Organs

by Arizona O'Neill

A heartwrenching memoir of a daughter losing her father and a scathing indictment of the medical industry

Arizona grieves at the hospital bed of her father, a man she hardly knew, brain dead after a fentanyl overdose. Doctors encourage her to act quickly to recast him as a hero by way of organ donations. Distraught, Arizona makes a decision that will haunt her for the rest of her life. As she struggles to come to terms with her father’s death and her role as next of kin in making his life’s last decision, she uncovers inconvenient truths about the organ industry’s own codependence on the opioid crisis.

Her parents were bohemian wild kids of 90s Montreal. He was a talented skateboarder, charming guitarist, and visual artist. She was an aspiring writer and outcast. They lived with other teenagers in the Plateau in a messy apartment filled with drugs, alcohol, and black-market animals. The city’s macabre history—McGill Medical School, the Mount Royal Cemetery, ancient cadavers at the Maude Abbott Medical Museum—takes center stage as Arizona sorts out fact from fiction.

Opioids and Organs is a damning critique of an industry that takes advantage of society’s outcasts. It is also the graphic novel debut of O’Neill herself, who weaves together a dramatic personal history with that of how humanity made its scientific advances. A muted yet striking pastel palette and a dolllike fantastical elegance belie both the gruesomeness of the book’s topic and the rage of its author.

Genres: Graphic Novels, Memoir, Nonfiction, Comics, Canada, Graphic Novels Comics, Family

380 pages, Hardcover

First published May 19, 2026

Reviews

[Olive Fellows (abookolive)]

I don't know how I, a massive Heather O'Neill fan, never knew that she had a daughter, nor how I accidentally stumbled into picking up her daughter's debut graphic memoir. 'Twas meant to be, I suppose.

Immediately upon starting this book, though, it's clear that the younger O'Neill shares many similarities with her talented mother: among them, an affinity for pairing the whimsical and the macabre. In this tome, Arizona takes on the very complex feelings she has about organ donation. And for her, it's personal.

About a decade ago, her father, a struggling addict, overdosed and was declared brain-dead. In the midst of receiving that shocking news, Arizona, as her father's next of kin, was asked to donate his organs. She did so, but now has very complex feelings about it, especially given the shadowy history of organ procurement and transplantation.

Although the subject matter is heavy, it's somewhat lightened by the fact that Arizona, in cartoon form, is accompanied on her adventures to learn more about the history of organ transplants in medicine by a very sassy lizard, Izzy, and Frankenstein's monster, Frankie. Each is meant to represent a different side of herself as she seeks knowledge and, hopefully, some form of peace.

I think if you're like me and you like the novels penned by Arizona's mother, you'll absolutely find it worth your time to read this, especially because Heather makes a few cameos. But if medical and/or macabre books are your thing and you enjoyed books like The Immortal Life of Henrietta Lacks, or the lesser-known but still important The Organ Thieves: The Shocking Story of the First Heart Transplant in the Segregated South (the subject of which gets a few pages in this memoir) definitely consider giving this a read. It certainly gave me a lot to think about.

[Chad]

A woman who just lost her father to a drug overdose finds herself questioning the organ donor system. It's interesting. I like the use of the first organ recipient, Frankenstein, as a sounding board. There's a lizard companion as well as she tries to come to terms with what happened. It's really long at 382 pages. I wish O'Neill found time to go into specifics about how hospitals use those organs, how much money the industry is making off these donations, etc.

[Isabelle Duchaine]

This absolutely is right up my alley - a graphic novel about the intersection between organ donation and the opioid crisis?? BUT I walked away feeling deflated and...angry? disappointed? unimpressed? by the storytelling, positioning and narrative structure.

first things first: on page 101 she mentions how her parents had a "baby monitor lizard, also known as a komodo dragon". FALSE - Komodo dragons are a *type* of Monitor, but there is absolutely no chance they or one of their associates smuggled in a baby komodo dragon and tried to raise it. it was probably another type of Monitor, which tbh is not a pet for the faint of heart but absolutely not the same thing as the worlds largest reptile.

next: I'm not sure....what she was wrestling with in this book? the medical system is discriminatory (yes). advances in medical science was based on experimenting on living and dead bodies - often without their consent or compensation (yes). medical professionals are eager to transplant viable organs into people in desperate need (yes). all these things can be true, but she hints at a broader conspiracy of physicians and society about allowing the Opioid crisis to continue so that we can keep 'harvesting" organs. it seems like she could have....done more research about that, because for all of the ineffective strategies and politics of tackling the drug crisis, this is not anywhere near anyone's strategic radar.

and finally - I am donating stem cells very soon. I signed up as a donor through Canadian Blood Services and have been matched with a recipient. so obviously I have strong feelings about the role of consent and the ability we have, through our bodies, to save lives.

[Aileen]

This was superb! Very thought provoking and informative.

Also, I LOVE Izzy.

[Jess]

I love a good graphic novel. So visually beautiful and interesting. I’ll read anything by the O’Neills!

[kate j]

finished on the amtrak back home … i wanted More from this book, i fear

[SJ]

Well that was fucking cool, and macabre, and funny, and sad AND educational. Extra points for the gecko. 🦎 Big Arizona O’Neill fan now.

[Ana]

Not really sure what O'Neills's point was with this novel. The narrative is a confusing mix of her experience of grief with information that presents to be insightful on organ transplantation, but is really just random trivia that serves to illustrate her points and does not do justice to its complex reality. Organ transplantation is an issue of increasing importance, as is the opioid crisis, and whilst controversial opinions are always invited to enrich our collective perspective, it is misleading and dangerous to present facts in a biased and sometimes erroneous manner to further one's agenda.

I think the sections that focus on her individual experience coming to terms with her father's passing and subsequent organ donation are very interesting and well supported by her drawings. However, she dabbles in the rich history of organ transplantation with diverse disconnected moments taken out of context, and does not do justice to the reality that those of us who work in organ transplantation know or face everyday. These sections I fear might contribute to increase public misunderstanding of this already very controversial and yet extremely important topic.

[Margaret Martin]

3.5 - decent debut, but the quality of the illustrations surpass the strength of the narrative.

[evie]

beautiful art but what was the point of this ?

[Maria]

4.5! What a beautifully haunting book. This is why I love reading graphic memoirs!

[Reve Gourdon]

Soo good I wasn’t expecting that! Make me question a lot of things about organs donation. Love it

[Andrea Winiarz]

I loved the illustrations. I would have preferred more of a fiction graphic novel than documentary facts.

[Sabrina]

I thought this was well done. Dark, quirky, and thought provoking.

[Charlotte]

was really looking forward to this but it literally felt like an informational pamphlet stretched to 200 pages

[Laurence]

"There's no longer such thing as originality, there is only creativity"
Pour moi, Arizona O'Neill est très certainement originale et créative. Ce roman graphique est unique.

En temps qu'intervenante j'ai été très touché de lire comment Arizona donne une voix aux personnes et aux corps des victimes de la crise de la toxicité des drogues.
La relation entre la crise et les dons d'organes était un angle mort pour moi et je tâcherai d'y porter plus attention.
Au delà de ça, c'est une histoire fabuleuse de deuil.

[Jeanelle d'Eon]

I didn't know what this was about when I picked it up and it was fantastic.

I hadn't really considered the increase in organ donations as part of the opioids epidemic or the fact that they had to change the definition of death in order to use a heart for a transplant.

[Amanda [Novel Addiction]]

This really made me think differently about organ donation, and the disparages in levels of care.

[Genevieve Cantin]

Un peu déçue, j’aurais aimé plus de profondeur dans le récit, qu’on aille plus loin au niveau de la crise des opioïdes notamment. Restée sur ma faim. Belles illustrations

[Véro]

Woah, such an interesting and unexpected topic. Arizona's imagination gave such an immersive quality to the book. I was hooked from the start.

[daphnée]

brilliant!

[Liz]

the art was evocative, but the text/thesis felt wobbly

[Siena]

Fantastic debut graphic novel! I learned so much about the organ donation system in Canada tied to the opioid crisis, all while enjoying Arizona’s amazing talents as an illustrator!

[Laurie Burns]

I have been a Heather O'Neill fan forever, and I was so pleased with her daughter's illustrations in "Valentine in Montreal" when I bought it last year, and thought it added whimsy and delight. I also a big fan of the @oneillreads account and seeing what these gals have been reading, and spoiler alert- hot girl, weird literature is on point!
I thought "Opioids and Organs" was extremely well done. I found the story moving and sad; but I also learned a lot and thought about organ donations, especially the way the Canadian and Nova Scotian (where I live) system is set up, in a way I never have before. Anytime I read anything that makes me think in a new way, I am pleased. Add in the adorable and occasionally very disturbing (in a good way) illustration and this is a graphic novel definitely worth reading! Out now from the wonderful folks at @drawnandquarterly.

[Kassie Frid]

As much as I enjoyed this I did feel there was something missing here; I suppose that is the endless exploration of grief.

I don’t want to compare too much, but after reading Lullabies For Little Criminals I was surprised by the connections I was able to make between her childhood and her mothers… I guess I’m just a sucker for memoirs buried in fiction.

[Marissa]

Clunky. Author clearly has mixed/negative feelings about organ transplant, and conducts research that supports her thesis. The feelings remain unresolved. Use of lizard as proxy is well done, but Frankenstein feels overly obvious and not nearly as well done.

[Karrie]

The art was great.

I feel like I need to note this was written by a Canadian and someone that is upset and is going to be biased. Because we are talking about death and addiction there’s a lot of strong feelings going on. Like the belief that no one cares about addicts, or how they are being used to fulfill organ donation lists.

1. No one forced anyone to do anything, so it was annoying to read how much blame was going on, except to their own.

There’s a ton of regret about author donating their father’s body for donation after he dies from overdose. I get it bc there’s limited time to make a decision.

FACTS: no one makes money donating organs. If religious people didn’t exist, we are very close to being able to clone/grow organs and probably won’t need donations in the near future, but until that happens, donations can make miracles happen. Canada and the US are NOT the same, and each state is different. Michigan has Gift of Life, which is a non-profit that works with all hospitals to find acceptable donors and is a free service. Meaning they pay for life support they are able to harvest parts if the patient is a donor or the family consents. They are the people who are called to come talk to the grieving family.

THIS IS WHY EVERYONE SHOULD HAVE A LIVING WILL/ADVANCE DIRECTIVE that CLEARLY states what their wishes are. Then you don’t force people to make those decisions. Get it notarized and TELL YOUR LOVED ONES. Get it signed or it doesn’t count. Put it in your medical chart NOW.

When I was a nurse and worked in Oncology, TONS of people die every day that are not acceptable as organ donors. I have had 1 patient that was able to donate their eyes (they use the corneas).

The book mentions a lot of research, but I think this is a case of what you don’t know, you don’t know, and her “facts” back up her opinion but aren’t quite true. There is NO conspiracy with healthcare workers. It’s offensive to say so.

ALSO: I know TONS of people in recovery. It’s offensive to make such a blanket claim that no one cares about addicts, when it’s simply not true.

Also 2016 is super late to be the beginning of the opiate crisis. That was the beginning of the fentanyl crisis and other opiate analogs being brought in from China. By 2016, it was almost impossible for prescription opiates to be available on the street BECAUSE of the opiate crisis (that began shortly after 1996, the year OxyContin was introduced).

I know a recovering alcoholic that was given a liver donation bc his was ruined from Hepatitis and addiction. That was over 10 years ago and he is still alive today. It was days, not weeks, from dying. This explains why there is not a magical Organ Donation List, bc recipients need to have compatible blood types and geography matters bc organs do not last long out of the body. A person with rare blood types will be passed up a lot until a match is made, and this is why people aren’t given a magic number where they are on the list.

Up until 15 years ago, Hep C was an incurable disease that severely damaged livers and millions died early in life than they probably would have if they didn’t contact it. Now it’s a 3 month treatment. It’s a huge breakthrough that doesn’t get a lot of attention.

No healthcare worker wants addicts to die so they can clear Organ Donations.

But it’s NOT ethical to pay people for their organs, so at this time this is the best we have. I know that the author’s father probably made the children of the man who received his heart, the best thing that has happened to them.

I lost my sister 16 years ago and I miss her every single day. I would have donated all my organs to save her.

[Jerrica]

A gorgeously macabre graphic novel, ultimately about how we conceive of death and dying. It exposed me to a different view of organ donation. While it saves lives, its origins are rooted in racism and classism. Should families be paid for the use of their loved ones' organs? That is a question posed in the novel, and one that I am definitely wrestling with. Obviously, the hospital profits off of the transplants.

The novel also addresses the opioid epidemic, and I first became interested in this novel after reading about the nasty, nasty Sackler family in Empire of Pain. While the Sacklers were the ones that kick-started this massive die-off of American and Canadian citizens, it is the citizens themselves that shoulder the blame. People that die of opioid overdoses are not treated the same as people who die of other causes. O'Neill argues that hospitals quietly accepted the opioid epidemic in order to rake in massive profits from free organ donations.

Additionally, O'Neill has a hard time dealing with the fact that the hospital kept her brain-dead father on life support in order to harvest basically all of his organs, especially considering the racism and other biases that go into organ waiting lists. She brings up that being a drug addict, her father would not have been able to get on an organ waiting list at all. Thus, he gave his body to a system that would not have given anything to him. Is that fair?

Throughout the novel, O'Neill is accompanied by a lizard, Izzy, and Frankenstein's Monster, whom she calls Frankie. They travel to Ireland to see her mother, a researcher, and then go to Paris, to the Catacombes, where I just was mere weeks ago! It was cool to see Paris illustrated in the novel. I found the Louvre and Catacombes illustrations especially moving. I agree with her that while the Catacombes are a bit scary, they're ultimately a calming place, and one of true equality, where the rich and poor dead mingle their bones for eternity. The novel ends in a really beautiful, life-affirming scene.

All in all, it's definitely an odd graphic novel, but one worth checking out and spending your time with! I'm surprised to see it doesn't have that many ratings and I hope more people find it.

[Alicia]

I might not agree with it but it's a damn good thought-provoking, anger-inducing creative graphic memoir and THAT is why books are the best.

O'Neill's dad dies of a fentanyl overdose. The doctors ask whether organs will be donated. She consents but ultimately is frustrated by her decision to do this thinking that the medical establishment preys on the weak and vulnerable to churn out organ donation especially in North America (she's in Canada but she also talks a lot about the United States). She researched and visited institutions related to the procurement of organs with their muddied pasts. She shares the catacombs of France. She discusses the historical significance of organ transplantation including cruel experiments on dogs and then humans.

While I agree that the past was a lawless wild west of sorts, to boil down current organ transplantation as preying on the weak and vulnerable is more about her pain and loss and anger. Having a cousin who received a heart transplant and an aunt who just passed away and donated her body to science, there are plenty of people who do it for reasons of medical advancement and we are in an age of medical advancement- it's why we're living longer. Not all organs could likely be harvested from people who she thinks are preyed upon because they might have underlying conditions that would prevent their organs from being used. She makes connections to the pandemic and opioid addiction that gave me moments of pause but I can't ultimately agree with. She makes the case though.

The story itself is told with her moving through time and space with both a lizard and Frankenstein who posit questions and pose thoughts in meaningful ways while she works through her frustration, anger, and grief.

The book is what Drawn and Quarterly does well. Unique. Challenging. Timely. I couldn't imagine not reading the book. It teaches and it gives readers pause to think.

[Veronica Molina]

No me tincaba por la portada. Pero veía que era de una ilustradora montrealina bien importante, su début de novela (gráfica), así que lo tenía en el radar.
Después me explicaron brevemente de qué se trataba. Tampoco me tincó mucho así.
Pero finalmente me enteré de que había sido hecho por la pareja de una persona que ha sido muy buena y acogedora conmigo, así que dije bueno, intentémoslo.
Y esperaba: drama, oscuridad, incomodidad por los dibujos y un tema denso.
Lo que encontré: una historia personal llevada a cabo de manera muy ligera y fluida, con interrupciones y aclaraciones rayando en el sarcasmo a momentos. Referencias literarias del tipo "¿sabías que Frankenstein era el doctor, no la criatura?" (amo). Y un tema que nos concierne como sociedad pero que no abordamos: el transplante de órganos.
Quizás la novela podría haber durado el doble. Pero siento que tiene una duración precisa, sin volverse tediosa ni densa.
Los dibujos son impecables en su estilo (que no es mi favorito, pero aprecio para este cómic). Las expresiones de los personajes dicen muchísimo.
La lagartija que acompaña a la protagonista le da un toque muy bueno de cuestionar/explicar algunos de sus comportamientos. Y Frankie? Un ente encantador.
Me gusta la fantasía de que una persona con un órgano transplantado recibe gustos/intereses de la persona de quien tomaron ese órgano.
El cierre no me mató. O sea, la referencia literaria sí. Pero que Arizona llegue a la conclusión que llega, y que por ende se vuelva accesible un "más allá", creo que no es tan coherente con su lado más investigador y hasta científico, con el que empaticé muchísimo.

En fin. Muy recomendable, excelente viaje para hacerse algunas preguntas antes de llegar a enfrentar la situación, si alguna vez toca, sobre el transplante de órganos.