"The Needle and the Damage Done" is a song by Neil Young that describes the descent into heroin addiction of musicians he knew. It was written about the heroin use 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 of the song from 1971 was part of the 2007 album Live at Massey Hall 1971. The album captured Young'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, Simple Minds, and The Pretenders; 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. Red Hot Chili Peppers bassist Flea has covered it while on tour in 1993 for the temporary departure of John Frusciante from their band. Cross Canadian Ragweed's Cody Canada performed the song acoustically on their 2006 release Back to Tulsa - Live and Loud at Cain's Ballroom.

Irish singer Andrea Corr covered it during her AOL Sessions on July 19, 2007 in support of her solo album Ten Feet High.

English folk singer Laura Marling covered it twice on her August 2008 tour of Australia.

English singer Pete Doherty covered it during a gig at the french festival eurockeennes de Belfort in 2009 and at the Roskilde Festival in Denmark in July 2009 as well as at the Belgian festival Lokerse Feesten in August 2009.

Pearl Jam's lead singer Eddie Vedder covered the song at a Pearl Jam show on August 23, 2009, at the United Center in Chicago, Illinois. He dedicated it to Michael Jackson, to whom he grew up listening. Pearl Jam also covered the song during their Backspacer tour.

Dave Matthews covered the song on January 29, 2010 at the 2010 MusiCares Person of the Year tribute honoring recording artist Neil Young. He also covered it, with guitarist Tim Reynolds, on May 20, 2010 at the D.A.R. Constitution Hall in Washington, DC, at an even for the Jane Goodall Institution.

Jewel covered the song on the Howard Stern satellite radio show on May 24, 2010.

• 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).
• In the ninth episode of the second season of News Radio Jimmy remarks to Dave the he's "...seen the coffee and the damage done," a reference to Dave's coffee addiction.
• Rolling Stone's cover story on Alice in Chains frontman Layne Staley, a known heroin addict, bears the title (Issue 727).
• A reference to its title can be found in the song "Understanding in a Car Crash" on the album Full Collapse (2001) by Thursday.
• A fourth season episode of Homicide: Life on the Street concerning the fallout from a drug war was titled "The Damage Done".
• "Song to Say Goodbye" from the Placebo album Meds (2006) includes the lyrical reference "your needle and your damage done".
• In 1994, several prison guards in Idaho were accused of playing this song to taunt death row inmates during a scheduled lethal injection.^[1]
• A reference to the title appears in the song "Genetic Design For Dying" from Aiden's album Nightmare Anatomy (2005)
• In 1997, the Skylab remix of the Depeche Mode song "Home" was titled "Home (The Noodles & The Damage Done)".
• Belgian death metal band Aborted's 2003 studio album was titled: "Goremageddon: The Saw and the Carnage Done".