from a back bay perspective.....
Like Z, this is frequently my first plug, or when traveling with two rods, which I frequently do, it's on one of them. They also cast great.
Needlefish are tough plugs for some people to get used to because you don't feel much. I use two types, and fish each a different way. If I'm fishing a spot where I think the fish are deep, and not actively feeding on the surface, I'll go with a Super Strike. They sink and will hold their depth if reeled slowly, so I use it like a "countdown" plug. They can be fished in the upper or lower water column, and anywhere in between. As Blasko pointed out, some will load them to get even deeper. I will sometimes put a teaser in front of a SS needlefish. Retrieve is slow to medium, and although I do not twitch, many swear by it, so try it both ways and see what works for you.
If there is a lot of surface activity, I have a couple of floaters (not sure who made'em) and I fish them by casting slightly up current and as they swing by, I pull my rod back smoothly (not jerking) and then drop the tip. This makes the plug move up current and then drop backwards. Aside from moving like (and creating a wake like) a real needlefish, I also think bass have a hard time laying off anything going backwards. Most of the hits come after I have dropped my rod tip.
These are the two methods I use exclusively, but as the previous posters have indicated, there are others. -Rich