They say the old laughing lady dropped by to call, and when she leaves, she leaves nothing at all.

There was a woman he knew about a year or so ago: she had something that he needed, and he pleaded with her not to go. On the day that she left, he died, but it did not show.

I’ve seen the needle and the damage done: a little part of it in everyone. But every junkie’s* like a settin’ sun.

* “junkie” originally refers to a drug addict, particularly one addicted to heroin, seeing as “junk” is slang term for heroin [source]. However, as the term developed in society, it has also evolved to refer to an enthusiasm for anything (such as a “book junkie” being obsessed with books.)

I caught you knockin’ at my cellar door: I love you, baby, can I have some more? Ooh, ooh, the damage done.

I hit the city and I lost my band: I watched the needle take another man. Gone, gone, the damage done.

I sing the song because I love the man! I know that some of you don’t understand [how you need to] milk-blood* to keep from running out.

* “milk-blood” most likely refers to the act of extracting heroin-laden blood, for reinjection at a later time. It usually is one’s own blood, but could also be the blood of someone who has just overdosed. It is done as “insurance” in case one’s heroin supply runs out. [source]

We are leaving, we are gone: come with us to all alone.  Never worry, never moan: we will leave you all alone.