You've done enough, relax, i'll finish tightening up this noose
The you here seems to be addressing the drugs themselves. They start El-P’s character here on a course toward death; now he will finish the job.
While “tightening up his noose” is a broad reference to his self destructive use of drugs, it could also more specifically be an allusion to “tying off” for heroin use.
To help improve the meaning of these lyrics, visit "Works Every Time" by El-P (Ft. Paul Banks) Lyrics and leave a comment on the lyrics box