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I believe he's trying to convey that he was/is having suicidal thoughts. It also could be that he's tried to commit suicide, because in the lines
"So I’m on my hands and knees Like a martyr calling out his final plea The executioner looks exactly like me, it’s me It’s getting easy"
I believe he's saying he regrets ever taking whatever is killing him, and he now realizes who killed him. It was himself.
"I wish I had a single thought the least bit legitimate enough To open up my mouth and spit accuracy"
also seems to be saying that he feels there is no thought worth living for, and that he can't say anything that seems to amount to anything at all.
I believe he's trying to convey that he was/is having suicidal thoughts. It also could be that he's tried to commit suicide, because in the lines
"So I’m on my hands and knees Like a martyr calling out his final plea The executioner looks exactly like me, it’s me It’s getting easy"
I believe he's saying he regrets ever taking whatever is killing him, and he now realizes who killed him. It was himself.
"I wish I had a single thought the least bit legitimate enough To open up my mouth and spit accuracy"
also seems to be saying that he feels there is no thought worth living for, and that he can't say anything that seems to amount to anything at all.