Lyric discussion by Erisian 

It's about drugs. Probably heroin. The dead sweat in his teeth, the "he's wearing your clothes, head down to toes a reaction to you, but you idiot kid, you don't have a clue..." is looking in the mirror and screaming at yourself about how stupid you are. Walking to see the man is going out to score a fix. And the whole time, you try to keep it kind of secret, "so leave me alone, you ought to be proud that I'm getting good marks" and that's the part that tears you up most because you can't talk about it to anyone.

while I agree there are obviously drug references, I'd have to say that judging by things I've read about Elliott in his early years that it's probably metaphorically about something else (like what captainspoot says). he hadn't gotten into drugs at this point but often fantasized about heroin addiction and related it to relationships and other emotional and non emotional dependancies.

I think the drug thing works, but also remember Elliott had stated in interviews he likes to use the imagery of drug use/addiction/abuse as a metaphor for love/relationships and other life events. So while on the surface, yes the drug angle makes sense, I think the ultimate meaning is deeper than that.

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