Or die, we dont know this, for nowRegarding the necklace I can only speak for the Nomad ending, but in my understanding V is discarding his old life.
V came to NC to become a legend, very akin to young men getting lured in by the gold rush some centuries ago.
Seeking fame and wealth V made a lot of wrong decisions and in the end was shot by Dex.
From then on survival in NC was the ultimate goal.
Now, leaving NC for good, realizing there is more to a good life than fame and fortune (namely a place to belong to with the avocados/love interest)V discards the necklace, ready to begin a new chapter.
Then V dies in 6 months, because reasons.