This episode received negative reviews. Even Trey Parker and Matt Stone admit to hating this episode, because it was made very quickly and not enough time was focused on it.
According to the audio commentary, this episode was originally going to be done in the style of "Intervention", with characters trying to convince Towelie to give up pot. This storyline was later explored in Crippled Summer (2010).
The title is a reference to the book by James Frey called "A Million Little Pieces" a autobiography, which was featured on Oprah and was one of her books of the month.
None of the main characters (Stan, Kyle, Cartman, Kenny) appear in this episode.
A poster on the wall behind one of the book publishers reads "Joy Luck Groove Back". This is a mashup of The Joy Luck Club and How Stella Got Her Groove Back.