On the DVD commentary, Trey Parker and Matt Stone said they hate Heavy Metal (1981) and the fact they had to watch it about three times to make the episode.
The first episode to garner an "S" (sexual content) sub-rating on its United States TV rating (TV-MA-LSV in full), mainly for frequent nudity.
The press conference Gerald has with his wife standing next to him was made to look just like when former New York Governor Eliot Spitzer publicly apologized for being a client in a prostitution ring in March 2008. His wife noticeably has the same eyes-half-closed look as Spitzer's wife during that press conference.
This was the first episode to be rated TV-MA-LSV
"Cheese" is actually a term for black tar heroin cut with acetaminophen and diphenhydramine (the active ingredients in Tylenol PM) not for someone who is high on cat urine. This particular type of heroin first showed up in Texas in 2005, it was popular among kids because of the fact that cold and allergy medicine like Tylenol PM was already widely abused by kids, and it was really cheap.