I've felt pretty strongly about this for years, never found anyone who cared to explore the idea. I think it's well known that the title of the album is a reference to the program, and that the topics in the album deal with cycles of addiction and abuse. However, what I'm specifically exploring here is how the individual tracks actually relate to the steps in the program. Some of the songs are dead-on related to the topic of the related step in the program. The 13th step can have several implications since it's beyond 12... it can mean relapse, is also used to refer to sexual advances/other abuses against AA/NA members, but in the context of the song and album, I believe it refers to a beneficial outcome of the process as a whole.

I'm not really an advocate of the 12 step program overall, and I don't really feel Maynard is advocating it by leveraging it in the album. However, it makes for a crux of conversation, and provides a framework much in the way that The Grudge analyses the internal cycle of a grudge and how it is resolved. If you look into the history of the 12-step program, it didn't originally start out so religious, evangelistic, or self-aggrandizing as the modern programs often turn out to be. It was a couple of guys analyzing their vices and helping each other figure out a systematic way of escaping a cycle of harm.