Songfacts®:

• Speaking to Billboard magazine, St. Vincent (real name Annie Clark), recalled how her intense workload caused her to use medication to get some much needed rest. "That one came pretty... it came pretty instantly. I had taken a sleeping pill because I was pretty jet lagged," she said. "And I looked down at it and was like, [singing] 'pills to wake, pills to sleep. pills pills pills every day of the week.' And it was just like, okay, I'm using the language of advertising to talk about a very personal story and also a very uniquely American macro story about capitalism run amuck on mental health, and an opioid crisis as a result. So how's that for a hit song of the summer?"
• The Guardian misheard the song as having a lyric about somebody being "defamed by fame", Clark said, the lyric is actually about someone being "de-fanged by fame... What I was referring to was that people's art sometimes suffers when they get into that too-big-to-fail mindset. How things get really boring when people get too risk-averse, or too comfortable, or when they have overheads that are too high."
• Cara Delevingne, the model/actress/singer that St. Vincent enjoyed an 18 month relationship with between 2014 and 2016, appears on this track singing the lyrics: "Pills to grow, pills to shrink, pills, pills, pills and a good stiff drink. Pills to f--k, pills to eat, pills, pills, pills down the kitchen sink." Speaking of her ex's feature, St. Vincent told Nylon:
  
  "It needed to be a posh British voice. I was like, 'Cara, wake up. I need you to sing on this song.' And she's kind of grumpy. And I'm like, 'Please. It sounds so good. One more time.'"
  
  Delevingne is credited as Kid Monkey in the album credits.
• The song also features additional vocals by Jenny Lewis, as well as saxophone from Kamasi Washington and drum programming by Kendrick Lamar producer Sounwave.
  
  St. Vincent first worked with Sounwave on a cover of the Stones' "Emotional Rescue" for the movie A Bigger Splash. She recalled to Pitchfork:
  
  "We hit it off and worked on a couple of other tracks together. When Kendrick was making DAMN., Sounwave came to my studio, and I just freestyled on guitar for a long time on different ideas that Kendrick was working on. None of that stuff ended up getting used on the record, but Sounwave is always looking for the next, the most innovative thing."