From the lyrics, it doesn't sound like he ever really expects to be in control of his fate, but instead of worrying about it he just lets go (possibly his near-death from the heroin and infection?). Only in being ready to meet death he found real freedom to enjoy the rest of his life, free to take whatever chances "come and go," free from worrying about other people's reliances on him. Whether from the drugs or the near death experience, he feels like he saw through physical reality to a "multi-dimensional scheme" of life and death and what comes next, and now he's "almost where he'll never be": in control of his fate.
From the lyrics, it doesn't sound like he ever really expects to be in control of his fate, but instead of worrying about it he just lets go (possibly his near-death from the heroin and infection?). Only in being ready to meet death he found real freedom to enjoy the rest of his life, free to take whatever chances "come and go," free from worrying about other people's reliances on him. Whether from the drugs or the near death experience, he feels like he saw through physical reality to a "multi-dimensional scheme" of life and death and what comes next, and now he's "almost where he'll never be": in control of his fate.