"The Needle and the Damage Done" is a song by Neil Young that chronicles the descent of musicians he knew into heroin addiction. It was written about the heroin use of (but before the overdose death of) his Crazy Horse guitarist Danny Whitten, and previews the theme of "Tonight's the Night," a song that addresses the heroin overdose and death of Bruce Berry, a roadie for Young and his band Crazy Horse.

"The Needle and the Damage Done" first appeared on the Harvest album in 1972. The song was recorded live rather than in the studio. It appears on the compilation albums Decade and Greatest Hits. On the handwritten liner notes included in Decade, Young had this to say about the song: "I am not a preacher, but drugs killed a lot of great men."

A recording from 1971 was part of the 2007 album Live at Massey Hall. The album captured Neil's introduction of his song thus:

Ever since I left Canada, about five years ago or so.. and moved down south.. found out a lot of things that I didn't know when I left. Some of 'em are good, and some of 'em are bad. Got to see a lot of great musicians before they happened... before they became famous.. y'know, when they were just gigging. Five and six sets a night... things like that. And I got to see a lot of, um , great musicians who nobody ever got to see. For one reason or another. But.. strangely enough, the real good ones... that you never got to see was.. 'cause of, ahhm, heroin. An' that started happening over an' over. Then it happened to someone that everyone knew about. So I just wrote a little song."

Bands that covered this song on studio albums include Our Lady Peace, Green River, Duran Duran, Lior, and The Pretenders; the Pretenders lost members to drug-related deaths. Punk rock band The Bronx recorded a cover which can be found as a b-side on the "False Alarm" single.

Red Hot Chili Peppers guitarist John Frusciante has covered it while on tour in Japan. Alternative metal band Seether covered it during a performance on Last Call with Carson Daly.

Cross Canadian Ragweed also covered this song on their 2006 release Back to Tulsa - Live and Loud at Cain's Ballroom.

• The song was the inspiration for The Sisters of Mercy's first 7" single, "The Damage Done" (1980).
• The title was also used as the album title for the second installment of the Nirvana: Outcesticide bootleg series (1995).
• A reference to its title can be found in the song "Understanding in a Car Crash" on the album Full Collapse (2001) by Thursday.
• Episode seven of the fifth season of Will & Grace was titled "The Needle & Omelet's Done" (2002). In the episode, Will gets botox for the first time (hence the needle). Grace goes to brunch with her boyfriend, during which she unwittingly meets his parents (hence the omelet).
• "Song to Say Goodbye" from the Placebo album Meds (2006) includes the lyrical reference "your needle and your damage done".
• The song's title was also featured prominently on a 1996 Rolling Stone cover referencing an interview with Layne Staley on his own battle with heroin addiction. (Issue 727)
• In 1994, several prison guards in Idaho were accused of playing this song to taunt death row inmates during a scheduled lethal injection.^[1]