When Neil Young left Canada for the first time he was able to see and meet many musicians who would later become famous. When he performed at Massey hall in 1971 he performed this song and stated that when he left Canada he was able to see great musicians who nobody else got to see. He elaborated that the reason for this was the drug heroin. This song The Needle and The Damage Done was written by Neil Young as a tribute to all the musicians who lost their chance at fame because of heroin.