Matt Green

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Matt Green For over 45 years, Matt Green has helped patients with Substance Use Disorder enter recovery & live a healthy sober life. In my 45 Years of clinical experience

Coming soon : A new book written by Matt - giving you an inside look at the mind of an addict.

10/25/2026

Inside the Mind of an Addict
Thoughts, Comments, Observations- Number 58
Are Addicts “Self-centered”?

Self - centered means being mainly concerned with yourself, your own needs, feelings, and interests, often without giving enough thought to other people’s feelings or needs.

I worked with a 45 year old male patient who had a severe co***ne problem. He first came to treatment at the order of the court. As he progressed through the treatment process, coming to both group and individual therapy he managed to stop using co***ne as well as other substances and began attending meetings of Alcoholics Anonymous.

One day he came to the group with a big smile on his face. He told the group that he had met a beautiful woman who he wanted to ask out on a date. The group members rejected this idea, quoting suggestions from AA that newly sober individuals should not start any new relationships in their first year of sobriety. My patient came back two weeks later telling the group that he is dating this woman.

Six months go by, my patient is still attending a group and announces at one of the group meetings that he wants to ask his girlfriend to marry him. The group members reject the idea advising my patient that in early sobriety the temptations to follow impulses without thinking them through can be dangerous, risking relapse. Two weeks later, my patient tells the group he is getting married.

Six months later, my patient tells the group that his wife is now pregnant. Group members question my patient on the speed in which his life has changed and advise him to focus on his recovery. Unfortunately 4 months into the pregnancy, my patient’s wife is told by her doctor that until the baby is born, she needs complete bed rest or be at risk of losing the baby.

My patient is devastated by this news. He does not know what to do. Once again, against the advice of the group members, my patient begins to take care of his wife all day every day, bringing her meals, flowers, gifts, taking care of the household chores, attending to her every need. One evening as he is bringing his wife her dinner, my patient enters the bedroom to see his wife sobbing as she is lying in bed. He asks her if he did something wrong, asks her why she is crying, what can he get for her. My patient is desperate to help her. Suddenly, she stops crying, looks up at him and says, “All I want you to do is hold me!”. My patient hears the words but does not know what to do. He looks at her and asks, “what is it that you want?”. She once again says, “Hold me!”. My patient, not fully aware of how this can help, climbs into bed and holds his wife as she falls asleep.

Comments are Welcome: My new book, “The Spy, His Umbrella and The Secret that Everyone Knows” - Inside the Mind of the Addict; will be released this fall. The book is filled with stories based on my experience with patients over the years. More to come.
# Clinical Insights

10/18/2026

Inside the Mind of an Addict
Thoughts, Comments, Observations- Number 57

The Power of : Attraction Rather than Promotion

As a younger clinician I was in the role of school psychologist working in the high school of a large public school system. My job was to evaluate students with learning and behavioral issues. At times I would use a battery of psychological tests as part of my evaluation and at other times, use clinical interviewing. I discovered that a number of the students were reporting use of illegal substances so I eventually included a substance use assessment as part of my evaluation.

After evaluating students, I would then prepare a report, and present it to a team of teachers, administrators and parents at an IEP (individual education plan) meeting to help determine how best to educate the student. At this school, in general, the same teachers, administrators, guidance counselors would come to the meetings as well as the parents of the student being assessed. Part of my goal was to help evaluate the student and at the same time educate the parents and school staff about substance abuse problems. Not all school psychologists at that time utilized a substance use evaluation as part of their assessment.

One day as I was walking down one of the halls of the high school on my way to a scheduled IEP meeting, an office door swung open suddenly and a hand reached out pulling me into the office. It startled me. The man in the office was one of the administrators who I worked with for years and was often in the IEP meetings. He closed the door to the office and locked it. I admit his behavior was out of character and it made me a bit nervous. He instructed me to sit down next to his desk. I did as he asked and he then sat himself on the desk so he was looking down at me. What happened next was a shock to me. He leaned over, looked me square in the eyes and said: “I have to tell you something!” I looked up and said; “Ok, what?” He then said; “ I am an alcoholic”!!” He went on to say, “I’ve been listening to you at our meetings talking about the students and their substance use issues and it made me think about my own drinking. I’ve stopped drinking and went to my first AA meeting last night.”

Comments are Welcome: My new book, “The Spy, His Umbrella and The Secret that Everyone Knows” - Inside the Mind of the Addict; will be released this fall. The book is filled with stories based on my experience with patients over the years. More to come.
# ClinicalInsights

10/11/2026

Inside the Mind of an Addict
Thoughts, Comments, Observations- Number 56

Is the Risk of Relapse ever diminished?

A 38 year old single man walked into my office seeking help. He had recently been arrested with his 3rd DUI (Driving Under the Influence) in the past 5 years. He was convinced he was going to jail. His court hearing was in a month and his attorney advised him that it would look better in court if he was in a treatment program.

Fast forward 2 years. My patient “drank the Kool-Aid”. He was attending 4 group therapy sessions a week, one individual therapy session each week, and going to meetings of Alcoholics Anonymous every day. His attorney had managed to delay the final court hearings to allow him to demonstrate to the court that he sincerely wanted to turn his life around. He came to the group the day of his hearing with his bags packed expecting to be taken to jail. Extremely anxious and afraid but sincere about his recovery, the judge allowed him to continue his treatment, but with no license to drive to review his case in a year.

Fast forward 15 years. My patient continued to attend treatment. At this point he was coming to one group therapy a week, continuing to participate in individual therapy as well as attending AA every day. My patient had an AA sponsor, was active in his AA meetings and most importantly had not used alcohol or other drugs in more than 15 years.

One evening during the summer months, my patient came into a group in tears. What had happened? My patient’s family owned a vacation house on Cape Cod. During the summer he would go on weekends to enjoy the ocean and relax. My patient had AA meetings to go to while he was on the Cape. On this particular weekend on the Cape, my patient was invited to have dinner at his neighbor’s house. It was an older couple who had known his family for years. They had dinner together regularly during the summer. That night as he was sitting on his neighbor’s porch, overlooking the ocean and talking with the couple something life changing happened. He looked down at the table in front of him to see a shot glass of wh***ey and a glass of b**r. He reached down, lifted the glass of b**r to his lips and then in a moment of terror, threw it down on the table. He looked at his neighbors and asked why this was in front of him? His neighbors looked at him and said, “You asked for it!” He had no memory of this request.

Comments are Welcome: My new book, “The Spy, His Umbrella and The Secret that Everyone Knows” - Inside the Mind of the Addict; will be released this fall. The book is filled with stories based on my experience with patients over the years. More to come.
# ClinicalInsights

10/05/2026

Inside the Mind of an Addict
Thoughts, Comments, Observations- Number 55

WARNING: The following post is a bit dramatic but not unusual when it comes to “Inside the Mind of an Addict”.

How the “Condition of Addiction” turns into a “Superpower”

If you have been reading these posts, you know that at our clinic we educate patients to understand addiction has little to do with substances of abuse or unmanageable, compulsive behaviors; it is about the way the addict's brain works.

A patient of mine grew up in the area, was an All Star football and baseball player at his high school and in his junior year he made the All American Team. Scouted by many Division 1 colleges for a potential 4 year sports scholarship, he missed his opportunity because of his active addiction.

My patient’s addiction became extreme in his later high school years to the extent that he woke up one morning in his own bedroom not remembering the activities of the night before with a hand gun on the night stand next to his bed that he had never seen before. His phone rang and his best friend was on the other end asking if he was safe because their other friend was in the hospital with a critical gunshot wound. My patient didn’t remember anything.

As years passed, my patient went into business for himself, selling co***ne and owning several properties in his area that he turned into houses of prostitution. At one point he had 6 houses and over 30 prostitutes working for him in addition to the co***ne business. One day the State Police and Federal Drug Enforcement Agency (DEA) agents raided one of the houses and arrested my patient on Federal Drug and Prostitution Charges. He spent 2 nights in jail, eventually bailed out by his father who was a wealthy land developer. Bail was $500K.

My patient’s father called several attorneys that he knew for help. One of the attorneys said if he was paid $50 thousand dollars he would guarantee that my patient would not spend one more night in jail and end up with several years of probation. Part of the probation conditions was continued treatment at our clinic.

During the several years of treatment, we talked with my patient about his strengths. He was an entrepreneur, had an instinct for business and was a self starter. If he focused in the right way, these strengths would become his “superpower”. My patient ended up tapping into these strengths and starting another business, this time legitimate and it became one of the wealthiest businesses in the area.

Comments are Welcome: My new book, “The Spy, His Umbrella and The Secret that Everyone Knows” - Inside the Mind of the Addict; will be released this fall. The book is filled with stories based on my experience with patients over the years. More to come.
# ClinicalInsights

09/27/2026

Inside the Mind of an Addict
Thoughts, Comments, Observations- Number 54

What about this idea Recovering Addicts talk about called, “Hitting Rock Bottom”?

In a recent group therapy session that I led, there was a discussion about “hitting rock bottom”. The question posed to the group was whether or not an individual needs to suffer only extremely negative consequences as a result of their behavior in order to change and enter recovery. Group members talked about their “rock bottoms” having to do with hospitalizations, overdoses, near death experiences, children taken away from them, divorce, family members not talking to them. People view the world and their experiences out of different lenses.

We talked about a story of a former patient who came in with his wife because his daily drinking and lying had become enough for her and she was threatening to throw him out of the house. She had threatened him many times but never followed through. She said this was the last straw; either he goes to treatment and stops drinking or she was done with him.

The patient agreed to attend one group therapy a week and his wife agreed to this plan. The patient came to the group in tears. His wife had thrown him out of the house because he was still drinking. He told the group he was now homeless, sleeping in his car. The group members tried to comfort him and then one of the members asked my opinion as the leader. I told the new member I thought if he didn’t attend an AA meeting he might miss the “miracle”. The member became very angry with me at this suggestion, stating that this suggestion was not worth the money he was paying to be part of the group, and then he stormed out of the room. I thought I would never see him again.

To my surprise, the following week he showed up again. He told the group how angry he was at me and said that when he stormed out he was headed to the liquor store. Before he got there he passed a church and somehow his car turned into the church parking lot. When he entered the church he discovered that an AA meeting was in progress so he sat in the back of the room thinking about how angry he was at me. Suddenly a man, who he did not know, tapped him on the shoulder, noticing that he was upset and asked him if he wanted to talk outside. He agreed and told the stranger all about the events that took place. After listening to this story, the stranger told him that he owned 2 sober houses and had an available room in one of them if he wanted shelter. The group member agreed, stayed in the house the rest of the week and did not drink. I guess he didn’t miss the “miracle”. Was that his “rock bottom”?

Comments are Welcome: My new book, “The Spy, His Umbrella and The Secret that Everyone Knows” - Inside the Mind of the Addict; will be released this fall. The book is filled with stories based on my experience with patients over the years. More to come.
# ClinicalInsights

09/20/2026

Inside the Mind of an Addict
Thoughts, Comments, Observations- Number 53

When are the “brain chemical messengers” that we call “dopamine” and “serotonin” high risk in the “addicts” brain?

As neuroscientists have known for a long time and now public knowledge is becoming more common, both “dopamine” and “serotonin” are chemical messengers in the brain. Dopamine is more strongly associated with motivation and reward while serotonin is more strongly associated with mood, sleep, appetite and digestion. Much of the public understanding of active addicts is the surge in dopamine which keeps the addict continuing to chase the high, expecting relief.

A male patient of mine, in his early 40’s, who has a 16 year old son and has 5 years of continued abstinence from his drug of choice which was fentanyl, works for a large company. His work day is busy, delivering materials to various departments and interacting with lots of people who work at the company. One of the departments he frequently visits is employee health which has a staff of mostly nurses and other support personnel. My patient particularly enjoys his trips to this department because over the past year, one particular female nurse who is around his age has been paying very close attention to him.

My patient finds this nurse very attractive and has found out through their conversations that she has two young children, is not married and enjoys relaxing at home and smoking ma*****na. Although my patient has been hesitant to talk about her in his group therapy, other group members are often asking for an update on his attraction to this nurse. My patient has not engaged in any romantic relationship since his fentanyl overdose 5 years ago.

Recently in a group, my patient’s romantic interest came up in discussion again. He told the group that this young woman has become more open with her desires, commenting to him about his physique and her attraction to him. My patient admitted to the group that he has had thoughts of going to her apartment, smoking ma*****na with her and engaging in sexual activity all weekend long. He is concerned about the ma*****na use being something that would send him into relapse but his urges to be with her are very strong.

The other group members posed this question to him, “ If your nurse friend came by one day, in her car and wanted to give you a ride home, would you jump into the car to take advantage of the opportunity?” The question is; have the flirtations with this nurse already created a surge in his dopamine and serotonin receptors before his first sexual encounter? Is my patient already in relapse before his first use of a substance?

Comments are Welcome: My new book, “The Spy, His Umbrella and The Secret that Everyone Knows” - Inside the Mind of the Addict; will be released this fall. The book is filled with stories based on my experience with patients over the years. More to come.
# ClinicalInsights

09/13/2026

Inside the Mind of an Addict
Thoughts, Comments, Observations- Number 52

How Do We Know When Patients are Making Progress in Treatment?

The topic of progress in treatment came up recently in one of my group therapy sessions. This topic is not new but occasionally comes up when patients seem to be doing well and then express, “I come to groups (treatment), I go to AA daily, I go to work, is this all there is? I don’t seem to have fun anymore!”

In this recent group, one of the newer group members who has been coming in regularly for 3 months, seemed to look different. He stopped drinking alcohol 3 months ago because his wife told him if he doesn’t do something about his drinking she would leave him. When my patient was drinking, he would start slowly, but end up drinking most of the day, get drunk and then get angry, sometimes violent and when the intoxication wore off he would regret what had happened.

My patient never experienced treatment before, let alone a group therapy. He told me before he began that he grew up in a neighborhood that was violent and in order to survive his choice was to run or to fight, so he chose to fight. As he grew older his body changed, he grew bigger and more muscular so people in the neighborhood became afraid of him. He told me he could never trust anyone and doubted that he would be able to contribute anything in the group.

For the first 7 weeks, in group, my patient came, on time, without fail, sat in the corner of the room with a baseball cap pulled over his eyes and listened without engaging with other group members. Some of the other group members would occasionally ask him about himself, but he declined to speak.

This past week, something changed. My patient came in on time as usual, but he wasn’t wearing his baseball cap. As the group started, he turned his chair toward the other group members. Fifteen minutes into the group time, my patient said his first words, commenting on the group discussion. From that point on, as the discussion continued he participated, and began to engage with the other group members. His final statement before the group ended was, “This is the most I have spoken with anyone in my entire life.” Are we looking at progress in treatment?

Comments are Welcome: My new book, “The Spy, His Umbrella and The Secret that Everyone Knows” - Inside the Mind of the Addict; will be released this fall. The book is filled with stories based on my experience with patients over the years. More to come.
# ClinicalInsights

09/06/2026

Inside the Mind of an Addict
Thoughts, Comments, Observations- Number 51

How Does a Package of Ground Beef Challenge Sobriety?

A patient with over 2 years of abstinence from his alcohol dependence, in one of my recent group therapy sessions shared the following story. He was shopping in the market for some ground beef and other small items so that he could have a barbecue at his home that evening. He brought the items to the self check out department at the market, scanned all the items and paid for them.

My patient was about to put the items in his back pack when he noticed that the ground beef was leaking, dripping blood from the meat. One of the store staff also noticed the drip and suggested to my patient that he go over to the Produce area to get a plastic bag so the meat would not drip into his bag. He made his way to Produce, secured the meat in the bag, put it in his back pack and headed for the exit.

As my patient approached the exit, a store manager stopped him. The store manager said he saw him put the meat in his bag and accused him of stealing the item. My patient told him he paid for it but the store manager didn’t believe him. Aggressive and provocative words were exchanged between the store manager and my patient. Both of them were angry and enraged.

Finally, the store manager went to the scan machine to print out the last receipt that was scanned, which was my patient’s receipt. The receipt showed that my patient had indeed paid for the meat. More aggressive words were exchanged and my patient exited the market.

In the group, as the story was told, various group members commented to their fellow group members how proud they were that my patient stuck up for himself after being threatened and harassed. When the praise settled down, I, as the group leader, posed a question to the group and the member who told the story. The question was, “ What do you think about the idea of going back to the store, finding the manager that you had the exchange with, and apologizing to him for your behavior?” Maybe the aggressive reaction on the part of my patient was like taking a drug. It provided the instant relief he was looking for in a stressful situation. Isn’t that the type of behavior that addicts in recovery are trying to change? Not “Sober” behavior!!

Comments are Welcome: My new book, “The Spy, His Umbrella and The Secret that Everyone Knows” - Inside the Mind of the Addict; will be released this fall. The book is filled with stories based on my experience with patients over the years. More to come.
# ClinicalInsights

08/30/2026

Inside the Mind of an Addict - Number 50
How Does a “Boat” Become an Addiction

Several years ago I had the opportunity to meet and become friends with a man who had a checkered past. At the time I met him he was in his late 50’s working for a private company that owned both Addiction Treatment and Mental Health Treatment facilities up and down the Northeast part of our country. This man was a recovering alcoholic and his role with the company was to drive potential patients to their residential care facilities in New Hampshire and New York. This man was not merely a driver however. On the ride to the facility he would talk to the patient, counsel them and introduce them to the world of addiction recovery.

In his 20’s and 30’s this man, who grew up in South Boston, very close to the harbor, was a terror in the community and in the court system. His alcoholic drinking caused him to engage in illegal behaviors to the point where local Judges knew him by name before he even entered the court room. He did multiple short engagements in jail, but when he was released his drinking picked up where he left off. Finally, through what he called “The Grace of God” he found Alcoholics Anonymous and through that program stopped drinking and became an advocate for sobriety through AA.

In his late 30’s this man married and had two children. When the children were older and out of the house, this man told his wife that he had always wanted to own a boat. Growing up in South Boston he was constantly going to the harbor and talking with people who owned boats. This became a dream of his, and now that he had some years of sobriety he wanted to make the dream come true.

He and his wife decided to buy a used boat that they could rehab together on weekends. The boat would serve to fulfill his dream and also to become a project for the two of them to work on together. They bought the boat and on weekends would go down to the harbor to work on it.

Six months went by. One day, this man came home and as he entered the house, he saw his wife standing there with suitcases in front of her. He asked her, “Are we going somewhere?” She looked at him with tears in her eyes and told him that she was leaving him. Why? She told him that it was the boat. When they first purchased the boat, together they worked on it on weekends. She said, now he is on that boat 10 hours a day, 7 days a week. They no longer have a life together.

Comments are Welcome: My new book, “The Spy, His Umbrella and The Secret that Everyone Knows” - Inside the Mind of the Addict; will be released this fall. The book is filled with stories based on my experience with patients over the years. More to come.
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