The title comes from the epigraph, so we'll rehash some of what we say in our "What's Up with the Epigraph?" section.
The epigraph is an original poem by James Frey about a Young Man who broke "something" into "a million little pieces." He asks for help and is told: "It can't be fixed […] It's broken beyond repair. It's in a million little pieces."
That's bleak, huh? The million little pieces could represent James's life before rehab. This guy pretty much did everything he could to break everything: himself, his friendships, his parents, his relationships, public property. He broke rules for the sake of breaking rules. And maybe he felt like that was his destiny: to be a rule-breaking failure. If that's the case, the rest of the novel is a slow crawl away from the despair of the epigraph.