I agree with Mastafarian. It sounds like he's trying to save someone from their addiction, possibly themselves (?). A lot of times when someone is so deep in their self-destruction they see the ones around them telling them to stop as evildoers who want them to stop feeling good, which they think only comes with being high, cutting, whatever. I think Matt is basically grabbing a friend by his shirt collar, telling him to stand up and "don't break down in front of me" and telling him that he's not going to give up even if his friend tells him otherwise.
Pretty good song, reminds me of some things my friends have said to me in the past.