Inside the Macabre World of Arizona O’Neill’s Opioids & Organs

Arizona O'Neill measures other cities against Montreal, not the other way around. She grew up in the Mile End, walks through Mount Royal Cemetery on the way downtown, and spent years working at Drawn & Quarterly before publishing her debut graphic novel with the press. That book, Opioids & Organs (2026), is about her father's death from a fentanyl overdose in 2015 and the organ donation decision she made in its aftermath.

But it's also, in its bones, a Montreal book: macabre, literary, and completely unashamed of both.

We sat down with O'Neill following of her book’s launch at Drawn & Quarterly to talk about making art in this city, the film grammar underneath her illustration work, and what it means to finally put her mother and her father in the same book.

Your publisher, Drawn & Quarterly, is a Montreal institution. You grew up here, you work at the bookstore, you've made videos about the city… Do you think there's an identifiable Montreal way of making art, or is that a romantic idea?

No, I think there definitely is a Montreal artist scene, and there always has been. A lot of it comes from the way that French Quebec consumes its own culture. There's a beautiful, blooming art scene here, and oftentimes in the Anglo scene we don't give enough credit to the work the French Quebec scene puts into it. But it's one of the reasons artists flock here—it's one of the places in Canada where Canadians are really consuming their own culture on a large scale. They have their own star system. And there's this kind of protectiveness that comes with being a Montrealer.

There's an obsession: we put other Montrealers on these pedestals and are just so proud of our own homegrown artists. When someone puts out something we can all be proud of, we all kind of feel a part of each other's art.

Drawn & Quarterly publisher Peggy Burns said you "capture the macabre spirit of Montreal." Does that mean much to you?

I know what she's coming from, because she's also coming from an outside perspective—sometimes we don't even realize we're in this macabre Montreal feel. I think it comes from having this giant cemetery right in the middle of our city. When I was a teenager, I spent a lot of time there, just seeing it as this beautiful place to walk through.

From where I live now, I'll sometimes take the route through the cemetery over the lookout down to downtown. It's always separating me. I've always lived in the Mile End and Plateau area, and having that mountain so close... I think that's where it comes from. But are we a dark people? I mean, we also have such a history with this underground belly, this red light district. Maybe there's a bit of macabre in our obsession with crime too.

You travel a lot for the research in this book—Paris, Dublin, Harvard. But McGill has its own complicated history with cadavers and medical ethics.

You could have spent the whole research process without leaving the city. What does Montreal specifically give you as a place to make this kind of work?

There is a critique of McGill in the book. But once it was coming out, I did a talk there with the curator of the Maude Abbott Medical Museum, which features in the book, and it was such a lovely exchange, a beautiful dialogue about how medical museums could do better and what they're already implementing.

The reaction could have been a very negative one, but instead they were very pleased with it. I think that says something about being Canadian: we consume so much American content that even if someone is being critical about something in our city, we are very excited to be mentioned. And that’s the thing about Montreal—when I'm in other cities, I'm always comparing them back here. I was in Toronto recently and I kept asking, ‘so, would this be your Hochelaga?’

Instead of doing the opposite, I bring Montreal with me no matter where I am.

You came up in film before illustration—your BA and MFA were both at Concordia's Mel Hoppenheim School. When you're composing a page, are you still thinking in cuts and sequences, or has the grammar become its own thing?

It's a mix. Even in film, there's this feeling that you don't want the frame to be boring—you don't want two talking heads with too much exposition. That was always on my brain, because there's nothing more boring than a page of repetitive drawings with two people just talking back and forth.

I really wanted every page to be different from the one before it, with an unpredictability in the framing. But I think that's in film, too—you think about composition, where's the light coming from, where's the eye going. There are moments in the book that feel very cinematic to me. There's a reveal near the end where I'm walking through the forest and you come to this large Alice in Wonderland panel; that felt very cinematic. Or a cut where you see my parents in a lost apartment and then cutting to them in the same position.

When I was scripting the book, I literally wrote it like a screenplay first. For me, film and comics are almost more closely related than traditional writing and comics.

Your editor pushed you toward digital colouring after about ten months of drawing by hand. What did that actually change—not just practically, but in terms of what the pages feel like?

It was the best decision, absolutely. When I went into the Drawn & Quarterly office with my stack of hand-drawn pages, they pointed out that painting directly onto them was risky—if you make a mistake over 400 pages, you might have to redraw the whole thing. And painting over the black lines could ruin the line work. The other option was a lightbox, but that seemed insanely daunting.

So I learned to colour digitally. My first tests were horrendous—I was watching YouTube tutorials and it wasn't going well because everyone was obsessed with the technology, all these selection tools and shortcuts. Then I found this one older woman on YouTube who just painted with digital brushes the way you would paint by hand, layering the colours without worrying about selecting. That's what I did. I used one watercolour brush in Photoshop and just started painting as I would on paper. It also let me control the palette and stay consistent throughout, which was really important to me.

The book deals in body horror, but your palette is pastel, almost soft. Was that a deliberate counterweight?

I'm very inspired by children's literature—Where the Wild Things Are is one of my favourites, and there's definitely an influence from those muted, haunting, almost vintage-y tones. But in general I just really like pastel palettes. I think it also comes from loving a level of sweetness in an image. Honestly, I was constantly trying to push myself toward more horror while I was making it—constantly thinking, more macabre, more disgusting—and then I'd draw it and it would come out as this almost soothing imagery. And I'd think, of course. I can't change myself. So it was maybe 50 percent thought and 50 percent just the way the art comes out of me.