This song is about climbing back to the top after you've hit rock bottom, specifically recovering from addition. Steven Tyler wrote it with Richie Supa, who collaborated with the band in the late '70s, co-writing their song "Chip Away the Stone."
Supa did a lot of drugs with the band and eventually got caught with a kilo of cocaine, which landed him three years in jail. After he got out, he went to an Aerosmith show at Madison Square Garden and met Tyler backstage... with an eight-ball of cocaine under his coat. Supa didn't realize that Tyler had gotten sober, and Steven called security to kick him out, telling him to come back when he had been off drugs and alcohol for a year.
Supa cleaned up, and after a year sent Tyler his Alcoholic Anonymous medallion to prove it. In the summer of 1991, they got together amid fears from Aerosmiths' management that Tyler would slink back into addiction in Supa's presence. Both knew they weren't going back to drugs and alcohol; when Tyler brought this up in a phone conversation, he told Supa, "Isn't it amazing?" which triggered the idea for this song.
Supa remembered something a client had said at one of his AA meetings: "I kept the right ones out and let the wrong ones in," which kickstarted his idea for the lyric about the descent into addiction and subsequent recovery. He flew out to meet Tyler, writing more of the lyric on the way, and when he go there, they finished the song in four hours - it was one of the first songs written for Get A Grip
. The pair stayed sober, and would team up again to write the Aerosmith hit "Pink