Bart is diagnosed with ADD after his latest prank during a "Fire Prevention Day" assembly at school, but his new medication makes him paranoid.
- As Himself: Mark McGwire
- Bait-and-Switch: Bart tells Lisa, "Did you know most people use ten percent of their brains?" Instead of saying something like, "Thanks to these pills, I'm using more than that.", but instead he says, "I am now one of them."
- Borrowed Catch Phrase: When Bart aims his tank at Springfield Elementary, Mrs. Krabapple, in an uninterested tone, utters Helen Lovejoy's "Think of the children."
- Call-Back: Homer mentions that he was banned from a water park for ten years (which, at the time of this episode's premiere, would be incorrect), which could be a reference to when he got stuck on the H2-WHOA! ride at Mt. Splashmore on the episode "Brush With Greatness." If it's not, then it's a Noodle Incident.
- The Cuckoolander Was Right: Major League Baseball was indeed spying on people, but rather than explain why, Mark McGwire dazzles the crowd with some dingers.
- Deranged Animation: The poses when Homer tries Focusyn.
- Everyone Has Standards: Skinner is horrified when Willy suggests killing Bart by dragging a hoe through his back and making it look like suicide.
- Irony: Everybody neglects the fact that Bart's unrelated prank of flooding the gymnasium accidentally saved Flanders' life by dousing the flames when Flanders set himself on fire. Even Bart was only thinking about his prank and couldn't predict the current would save Flanders strictly by chance.
- Of Course I Smoke: The straight-edged Ned tries to smoke a cigarette while performing in the fire safety play, though his coughing is actually the least of his problems as he inadvertently sets his pants ablaze.
- Riddle for the Ages / The Un-Reveal: Why was MLB spying on Springfield?
Chief Wiggum: Looks like the kid who roughed up the Wilson widow.
- Hosey the Bear, which can be seen in the beginning of the episode, is a reference to the United States Forest Service's mascot Smokey Bear.
- After Bart has flooded the school gym, Skinner can be seen wiping mud off his eyes in an homage to Oliver Hardy.
- Homer and Marge go to see Showgirls.
- When Marge reports Bart's disappearance to the police, Lou the police officer makes a drawing of Dennis the Menace.
- "When I can't stop my fiddlin', I just takes me Ritalin, I'm poppin' and sailin', man!"
- The title references The Rolling Stones song "Mother's Little Helper", which is also about drug addiction.