The members of Velvet Revolver had been through wild bouts of drug addiction and alcoholism which in many ways were the byproduct of the rock stardom they experienced with their previous bands (Scott Weiland was ex-Stone Temple Pilots; Slash, Duff McKagan and Matt Sorum were in Guns N' Roses). "Fall to Pieces" relates to their tribulations, specifically those of Weiland, who wrote the lyric. He said the song deals with two issues: 1) Coming to terms with his heroin addiction. 2) His relationship with his second wife, Mary, which was falling apart. In both cases, Weiland felt like he was "falling to pieces."
Musically, the song was built on a riff Slash came up with. The guitarist could certainly relate to the sentiment of the song: he was once declared medically dead after suffering from a drug overdose and collapsing near an elevator at his hotel. Paramedics rushed in to save him, giving him an adrenaline shot which saved his life. Unfazed, he signed himself out of the hospital that night, returned to the hotel and flew to the next stop on the tour.
When Velvet Revolver played this in Maryland on Scott Weiland's anniversary, he dedicated the song to his wife, explaining that she was one of the people who helped him overcome his addictions and alcoholism.
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