Regarding its lyrics and subject matter, Bowie himself has claimed that "Blackout did indeed refer to power cuts". However NME's Roy Carr and Charles Shaar Murray considered it to have "overtones of Bowie's personal blackout in Berlin (where he collapsed and was rushed to hospital)", noting the line "Get me to the doctor’s" and an atmosphere of "disorientation, fragmentation, panic". Nicholas Pegg surmised that, by the same token, the line "Someone's back in town, the chips are down" may have referred to his wife Angie, who had just arrived in Berlin around the same time.
A concert performance recorded in the spring of 1978 was released on the live album Stage. This version was also released as a single by RCA in Japan in November 1978, backed with "Soul Love" from the same series of concerts.