The song was written on the back of an envelope by Lou Reed while he and the band were on their way to a gig at the Café Bizarre. The song details a number of characters living in New York City, including Teenage Mary, Margarita Passion, Seasick Sarah, and Beardless Harry; all of whom are detailed using or seeking drugs. In addition to mentioning New York scenery such as Union Square and 47th Street, the song makes use of drug terms paired with religious imagery. Two of the four verses directly speak of heroin use, a theme found in the album. In the song, Marguerita Passion tried to sell her soul in order to get "a fix", while Seasick Sarah "turned blue", causing her angels to panic. The song is also well known because of Lou Reed's guitar solo, and its lack of a conventional approach.
Električni Orgazam's lead vocalist, Srđan Gojković, recorded a cover version of the song for an art exhibition of Andy Warhol's works at the Modern Arts Museum in Zagreb, released in 2008 on his compilation Muzika za film, TV i muzej.