Tony Banks added an ominous chord progression, establishing the song's dark tone and inspiring its lyrics, which depict a drug addict’s struggle to contact their dealer for another fix.

The lyrics explore themes of addiction ("a load on your back that you can't see," "shake it loose"), desperation ("I've got to get it to you," "I keep calling but you're never home"), and eventual anguish ("now I'm in too deep," "please get me out of here!").

The album version extends to nearly nine minutes, including a refrain and keyboard solo, which were cut from the single and radio edit.

[citation needed] Cash Box said it has a "remote, eery...ambiance that features Phil Collins' emotional singing and propulsive drumming.

This was a weird period of time where seemingly half the songs on the radio were either by Genesis or one of the many offshoot acts like Phil Collins, Peter Gabriel, Mike and the Mechanics, or GTR.