First and foremost, I must give the producers and writers credit for choosing one of the most unusual titles in recent memory. I'm sure this one raised a few eyebrows. Maybe it's just how I was brought up, but that was always considered a relatively vile thing to say in public. Times change, however, and I suppose this is just another example of how much they change. Besides, it's not like they're particularly wrong.
Much like the previous episode, this is a stand-alone affair with plenty of connections to the overall arc. And, as usual, the strength of the episode is not the case itself, but how it pertains to the Brothers Winchester. (I know I consistently repeat myself on that note, but it's important to reinforce what makes this show something more than it appears.)
This was all about Sam and his realization that the current war is not going well. If Lilith is more than halfway to her goal (and almost exactly halfway through the season, of course), and the angels are losing the battle to keep the seals from opening, then Sam has a pretty damn good reason to be worried about the future.