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Anthony Hopkins: From Alcoholism to Knighthood

Anthony Hopkins: From Alcoholism to Knighthood

Did you know that Sir Anthony Hopkins is in recovery from alcoholism? While today, the Academy Award-winning actor is known for such iconic roles as Dr. Hannibal Lecter, President Richard Nixon, Methuselah, and Odin, among others, there was a time when his fondness for drink threatened the career that he was building. But in an industry infamous for permissiveness and enabling, Hopkins overcame his addiction to alcohol and has been able to successfully maintain his sobriety for more than 40 years. Let’s take a closer look at the inspiring story of a man who is LITERALLY Hollywood royalty—Sir Anthony Hopkins—and how he overcame his addiction to alcohol.

“Get your loved one the help they need. Our substance use disorder program accepts many health insurance plans, this is our residential program.”

A Six-Decade Career

By a series of accidents, I became an actor, and I thought that would fix me. I thought that if I could work hard and really achieve success, then I would be fixed—the feelings inside me would go away.” ~ Anthony Hopkins, in an  Alcoholics Anonymous Speaker’s Meeting Phillip Anthony Hopkins was born in 1937 to working-class parents in Margam, Wales. Habitually a poor student, he would later recall how his academic struggles “left me open to ridicule and gave me an inferiority complex”. In school, he was nicknamed “Dumbo”. Influenced by another prominent Welsh actor, Sir Richard Burton, Hopkins was bitten by the acting bug as a teenager, graduating the Royal Welsh College of Music & Drama, and later, the Royal Academy of Dramatic Art. Hopkins made his professional debut in the theater in 1960. Within a few years, he became the understudy of the great Laurence Olivier, who said that Hopkins showed “exceptional promise”. But the theater bored Hopkins, who hated repeating the same lines again and again night after night after night. He began to move into television and film roles. His “big break” came in 1968, for The Lion in Winter. He played Richard the Lionheart and was nominated for the prestigious BAFTA Award. Katharine Hepburn, his co-star in the film, said to Hopkins, “For God’s sake, I hate you drinking actors. I don’t know what’s the matter with you, you’re all killing yourselves.” After that early recognition, Hopkins became a steadily-working actor. Since then, he has almost 80 film credits and close to 40 appearances on television. He has earned both popular and critical acclaim, winning an Oscar, two Emmys, a Golden Globe, and five BAFTAS, among others. Honored for his contributions to the arts, Hopkins was knighted in 1993.×368.jpg

Public Success, Private Struggles

Nothing ever satisfied me. It could be an ocean of booze…nothing would ever satisfy me. Work…success…NEVER FILLS THE CUP.” ~ Anthony Hopkins But from his early 20’s, Hopkins was a heavy drinker. During his theater years, while other members of the cast would get together for dinners, he would be in the pubs, downing eight pints a night. On films, he would often show up after a night of drinking after not having slept the night before. But his “bad boy” behavior only cemented his reputation as an acting firebrand. Hopkins says that his drinking affected how he felt during his young adulthood. “I hated the Sixties. It was one long wet Wednesday afternoon…For most of it, I was drinking myself into oblivion…Most of the people were miserable, and they’re all dead and gone now.” Hopkins recalls that there are even movies he doesn’t remember doing because he was so drunk. During the filming of The Lion in Winter, for example, he bonded over alcohol with his co-star, Peter O’Toole, saying “I had some bizarre nights with Peter when we made The Lion in Winter, but to be honest I don’t remember them. He enjoyed his drink – and I did, too. We weren’t close friends or anything, but we got drunk very quickly…

“We treat both addiction and co-occurring disorders and accept many health insurance plans. Take a look at our inpatient program.”

What is Alcoholism?

“I carry around in my body and in my personality a seemingly-hopeless disease which is terminal, progressive, and will kill me.” ~ Anthony Hopkins Alcoholism—properly called Alcohol Use Disorder— is a disease characterized by extreme alcohol abuse. At this point, the person’s life has become unmanageable because of their uncontrollable drinking. AUD is:

  • Incurable
  • Chronic—It lasts a lifetime.
  • Progressive—Left untreated over the long-term, it will invariably cause significant damage to physical and mental health.

But it is also important to understand what AUD is NOT:

  • A choice
  • A weakness
  • A moral failing
  • A lack of willpower
  • A product of bad upbringing
  • Anyone’s “fault”

What Causes AUD?

There are multiple genetic, environmental, and behavioral factors that contribute to a person’s likelihood of developing AUD:

  • A close blood family member with AUD
  • Exposure as a child to parental alcoholism
  • Experiencing or witnessing trauma
  • Peer pressure
  • Living in a culture where substance abuse is normalized
  • Early initiation of use
  • Co-occurring disorders such as anxiety, depression, PTSD, disordered eating, bipolar disorder, etc.

How is AUD Diagnosed?

AUD is one of the manifestations of a larger illness, Substance Use Disorder, more commonly known as addiction. SUD is a medically-diagnosable mental disorder that has identifiable symptoms, as set forth in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders:

  • Consumes a large amount of alcohol over a long period of time—Hopkins regularly drank heavily for 15 years.
  • Cannot control when or how much they drink—Hopkins got drunk even when working.
  • Suffers health issues because of drinking—Hopkins experienced blackouts. Also, at 38, his doctor told him that if he continued, he wouldn’t make it to 40.
  • Engages in risky behaviors when drinking—Hopkins would frequently drive drunk.
  • Makes unsuccessful attempts to cut back—Hopkins could never abstain from alcohol longer than six weeks at a time.
  • Loved ones show concern—Hopkins mentions how his then-wife would cry because of his drinking.
  • Negative consequences—Eventually, Hopkins’ wife left him, believing he was going to drink himself to death.
  • Continued usage—After the breakup of his marriage, Hopkins was determined drink himself into the ground. Only a chance encounter with a woman in the liquor store prevented that.

The disease of alcoholism manifests differently in different people, and not everyone will exhibit the same symptoms. While Anthony Hopkins exhibited the above signs, others might demonstrate their illness through an increasing tolerance for alcohol, withdrawal symptoms, legal problems, or severe chronic illness, for example.×600.jpg

Alcohol Use Disorder Statistics

“It was like being possessed by a demon, an addiction, and I couldn’t stop. And millions of people around like that. I could not stop.” ~ Anthony Hopkins Per the National Institute on Alcohol Abuse and Alcoholism, alcohol use—and abuse—is extremely common in America:

  • Over 86% of US adults report drinking alcohol at least once.
  • 70%+ admit to drinking within the past year.
  • More than half have drunk during the last month.
  • 7% drank “heavily” within the past 30 days.
  • 27% say they binge-drank.
  • In 2015, the most recent year available, over 15 million American adults met the criteria for an AUD diagnosis.
  • That breaks down to almost 10 million men and more than 5 million women.
  • Despite that, only a little more than one million received treatment that year.
  • Annually, there are 88,000 alcohol-related deaths in the US.
  • Alcoholism is #4 preventable cause of death in this country.

Additionally, the Centers for Disease Control and Prevention reports:

  • 1 out of 4 US adults drank “heavily” within the last year.
  • This is defined as 5+ daily drinks for men, and 4+ for women.
  • Every year, over 19,000 Americans die because of alcohol-related liver disease.
  • Another 30,000+ die because of homicides, accidents, and other incidents involving alcohol.

Finally, the World Health Organization estimates that alcohol is involved in:

  • 3.3 million global deaths annually
  • 1 death every 10 seconds.
  • Nearly 6% of all deaths
  • Just over 5% of the disease and injury burden
  • 25% of all deaths in the 20-39-year-old age demographic

Drinking Habit or Drinking Problem?

Nobody quite knows which drink it is that takes him over the edge of being merely a social or hearty laughing drinker into a morose and hung-over wretched creature who shakes and creaks, sweats, and has nightmares…” ~ Sir Richard Burton, who was himself a notorious toper HOW MUCH you drink matters. The NIAAA defines “heavy/increased risk” drinking as:

  • Binge drinking on 5 or more occasions during the past 30 days.
    • Men: 5 or more drinks within a single two-hour sitting
    • Women: 4 or more drinks a single two-hour sitting
  • Daily or Weekly drinking
    • Men: More than 4 drinks per day/ More than 14 drinks per week
    • Women: More than 3 drinks per day/ More than 7 drinks per week

Significantly, just 2% of drinkers who drink below the increased risk or heavy thresholds go on to develop AUD. NEGATIVE CONSEQUENCES matter Excessive drinking becomes a problem when other areas of life are negatively impacted:

  • Legal issues – Public Intoxication, DUIS, jail time, attorney’s fees, fines, etc.
  • Difficulties at school or work – Poor grades or performance, inordinate tardiness or absenteeism, reprimands, suspension, expulsion, termination, etc.
  • Relationship troubles– Arguments, breakups, separation, divorce, domestic violence, child abuse, etc.
  • Health worries – Blackouts, liver disease, cardiovascular problems, cancer, brain damage, etc.
  • Money problems – Frequent or prolonged unemployment, unpaid bills, evictions, repossessions, etc.

A LOSS OF CONTROL matters If a person wants to stop drinking because of the negative consequence – but they are UNABLE to – then they have lost control of their “habit” and have progressed to full-blown addiction. Here’s the thing – because AUD is progressive, their illness will only get worse, perhaps to the point of permanent damage to their health… or even death.×683.jpg

Why is Alcohol So Addictive?

“I’m glad I’m an alcoholic. I wouldn’t have missed it for the world. Of course, I’m sorry for the hurt I caused people… but being an alcoholic was an amazing and powerful experience. There were some days when I’d drink a bottle of tequila and I didn’t care if I died. I loved tequila.” ~ Anthony Hopkins Alcohol and other drugs of abuse directly affect the regions of the brain responsible for:

  • Reward
  • Pleasure
  • Learning
  • Motivation
  • Decision-making
  • Impulse control

When any action necessary to survival, such as eating or sex, is performed, the brain releases dopamine, the naturally-occurring neurotransmitter responsible for pleasure. Intoxicants trick the brain into triggering a dopamine surge that in many cases is faster and longer-lasting than natural behaviors. At the beginning, in other words, people drink because it FEELS GOOD. In very short order, the person’s brain LEARNS to associate drinking with REWARD and PLEASURE, so they are MOTIVATED to do it again. And because their ability to make sound decisions and control their impulses becomes impaired, they become prone to alcohol use, even in dangerous or irresponsible situations. Over time, however, the artificial over-stimulation of the reward pathways causes the brain’s receptors to shut down, resulting in a diminished response to alcohol. This is known as tolerance, and that means that the person must consume ever-greater quantities in order to realize the same pleasurable effect. By this point, the need to drink is starting to become compulsive. But the real problem arises whenever alcohol isn’t available or the person tries to stop drinking. The disrupted dopamine production means that the person is no longer able to feel pleasure or motivation normally. In fact, they become unable to even function without the presence of alcohol. When not drinking, they may also begin experiencing the harshly-unpleasant and possibly-dangerous symptoms of alcohol withdrawal. Now, they have lost the power of choice. They must drink, to keep from FEELING BAD.

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More about Alcohol Withdrawal Syndrome

When someone with a long personal history of alcohol abuse or addiction stops drinking abruptly, their brain goes into a state of hyperexcitability, the opposite of the sedating effect that alcohol has. As a result, they experience disturbances in the autonomic and central nervous systems. Within as few as six hours after the last drink, symptoms will start to manifest:

  • Agitation
  • Anxiety
  • Hallucinations
  • Headache
  • Increased body temperature, heart rate, and blood pressure
  • Insomnia
  • Irritability
  • Nausea and vomiting
  • Seizures
  • Sweating
  • Tremors

Roughly half of all alcoholics will suffer withdrawal when they stop drinking. These symptoms usually last 3-4 days, but in extreme cases, they may persist as long as one week. But the real danger of alcohol withdrawal is a condition known as delirium tremens – “the DTs”. 1 out of 5 chronic alcoholics will develop this extremely serious – and potentially DEADLY – symptom. Typically presenting two days into alcohol withdrawal, the DTs are characterized by the rapid onset of global confusion, a loss of external reality, and severe hallucinations. Extremely-high body temperatures and seizures may result in death. In fact, without treatment, delirium tremens is fatal in over one-third of cases. Even with treatment, unfortunately, approximately 15% of DT patients will still die. The three main risk factors for delirium tremens are:

  • Long-term alcohol abuse – 10 years or more
  • Age – middle-aged or elderly alcoholics are more-risk
  • A personal history of alcohol withdrawal – each instance increases the risk of serious complications

Because withdrawal is so hard and so dangerous, a person with AUD should NEVER abruptly quit drinking “cold turkey” and should ALWAYS detox from alcohol under the close supervision of trained medical specialists.×604.jpg

Why Willpower Alone Won’t Work

“Using addictive drugs can evolve from controlled social use into the compulsive relapsing disorder that characterizes addiction… Advances over the last decade have identified the brain circuits most vulnerable to drug-induced changes, as well as many associated molecular and morphological underpinnings. This growing knowledge has contributed to an expanded understanding of how drugs usurp normal learning circuitry to create the pathology of addiction, as evidenced by involuntary activation of reward circuits in response to drug-associated cues and simultaneous reports of drug craving.” ~ Charles O’Brien and Peter Kalivas, the September 2007 edition of Neuropsychopharmacology Just read some of those words and terms – “involuntary”, “drugs usurp normal learning”, “vulnerable”, and “compulsive”. This clearly conveys the idea that addiction in any form – including alcoholism is not a choice. Addiction is a disease of the brain influenced by many causal factors, including genetics. Alcoholics are biologically vulnerable, to the point that even “social” drinking affects and alters their brains far more profoundly than those of people who are not genetically predisposed to addiction. This is particularly significant because, as a disease, AUD isn’t affected by such things as choice or willpower. To be clear, you can’t reason with alcoholism, and all the nagging, arguing, screaming, begging, threatening, and judging won’t help. Willpower and well-wishes won’t work. As Hopkins himself said, “I’d given it my best shot. I’d tried to beat this with willpower. And I failed miserably all the time…”

Multi-Generational Alcoholism

“Towards the end of his life, he used to drink, and he was unpredictable. Never violent, but sudden turns of rage, and then deep depressions. Turned on my mother, turned on me.” ~ Anthony Hopkins, speaking about his father, Dick Often overlooked is how parental drinking influences a child’s current and future use of alcohol. It’s called “Generational Substance Abuse” – when the disease is passed down from parent to child.

  • Most children are introduced to alcohol in the home.
  • Parental approval or disapproval of drinking strongly influences teenagers’ behaviors.
  • 82% of parents who drink raise drinking children.
  • Similarly, 72% of parents who don’t drink raise children who also don’t drink.
  • Drinking fathers have the strongest influence on their daughter’s use of alcohol.
  • Alcohol use by the mother profoundly affects the drinking habits of children of both sexes.
  • 77% of those mothers who take more than one drink of beer or wine have children who will use alcohol or drugs.
  • Greater than 18% of adolescents age 12-17 whose fathers drink use illegal drugs. This happens even if the father DOES NOT have AUD.
  • The more family members with AUD a child has, the greater their likelihood of substance abuse.

Of special relevance, Hopkins’ estranged daughter, Abigail, has also battled substance abuse.×400.jpg

How Peer Pressure Influences Problem Drinking

“…I noticed the women were sipping their ports and brandy, but all the men were, ‘Come on, drink! Drink!’ I thought, ‘There’s something very Greek about this.’ Men together…a kind of bonding.” ~ Anthony Hopkins, discussing a get-together after Sir Richard Burton’s death According to a 30-year study conducted by Harvard Medical School, a person’s close social connections shape their drinking behaviors. For example:

  • People with a heavy-drinking friend or relative are 50% more likely to drink heavily themselves.
  • When the connection was a friend-of-a-friend, however, the risk fell to 36%.
  • And when it was a friend-of-a-friend-of-a-friend, the likelihood dropped to just 15%.
  • Individuals with a teetotalling friend or family member were 29% more likely to abstain from alcohol use.
  • The quantity also mattered—those who were “surrounded” by heavy drinkers had a 70% greater chance of doing the same.
  • Likewise, someone who had several non-drinking friends were 50% more likely to abstain.
  • Gender mattered—the friends of women who started drinking heavily were at doubled risk.
  • On the other hand, when men started to drink heavily, their friends’ habits didn’t change.
  • Men with heavy-drinking wives are at tripled risk of starting to do the same.
  • Wives with husbands who drank excessively were twice as likely to join in.

The study, which was published in the Annals of Internal Medicine in 2010, followed 12,000 men and women over a 30-year period. This highlights why one of the first lessons an alcoholic is taught in early recovery is the importance of avoiding the places, things, and PEOPLE associated with their past drinking. Sometimes, this means finding a whole new set of friends.

How Anger Fuels Alcoholism

“But the anger, you begin to channel it. I’m very happy I’m an alcoholic – it’s a great gift, because wherever I go, the abyss follows me. It’s a volcanic anger you have, and it’s fuel. Rocket fuel. But of course, it can rip you to pieces and kill you.” ~ Anthony Hopkins Anger and substance abuse go hand-in-hand. Not only is the primary manifestation of the disease driven by anger, unresolved issue can also trigger a relapse during recovery. Why might this be the case?

  • Past trauma
  • Helplessness
  • Misdirected blame
  • Self-anger

If a person hasn’t learned or doesn’t practice healthy coping methods, then drinking may be one of the only ways they have to deal with feelings of anger. Of course, this is counterproductive, because alcoholism causes more problems, which the person address by drinking, which causes even more problems…it is a damning downward spiral. This is why much of the recovery process is spent learning and practicing newer, healthier ways to cope with stress and emotional pain.

Denial Keeps Alcoholism Alive

That’s denial—looking down in the gutter, facedown in the gutter, and saying you’re not dying.” ~ Anthony Hopkins Alcoholics also cope by denying their problem. That allows them to avoid the painful reality that their drinking has gone beyond their control and is affecting their life. This refutation of reality does several things for the alcoholic:

  • Allows them to avoid confrontation with those who might try to get them to stop drinking
  • Keeps them from facing the consequences of their self-destructive behaviors
  • Salvages their self-esteem
  • Is easier than doing the hard work of recovery

But the biggest reason why alcoholics live in denial is because as long as they don’t have to admit that they are sick, they don’t have to get better. In other words, denial helps preserve their addiction to alcohol. There are several ways to be in denial:

  • Minimization – Diminishing how serious the problem really is –“I don’t drink THAT much.”
  • Rationalization – Offering excuses — “I DESERVE to drink. I work hard.”
  • Blame – Making someone else responsible – “It’s my boss’s fault that I drink!”
  • Anger – Isolation through hostility – “You can’t tell me what to do!”
  • Self-deception – Lying to one’s self – “I can quit ANY TIME.”

This is why the First Step of Recovery is so important – the person must clearly admit that they have a drinking problem. Only then can they begin to move forward.

Alcoholic Subtypes

I guess that’s why we get drunk and use drugs, because life is constantly disappointing us. We have such a lust for life, and life is constantly letting us down. So, we commit suicide slowly on the installment plan.” ~ Anthony Hopkins Addiction specialists have been able to classify the different types of alcoholics. This is important, because this identification makes it easier to create individualized treatment plans that can address the specific manifestation of the disease.

Young Adult

32% of all alcoholics Early 20s Low rate of AUD within the family Rarely suffer from a co-occurring mental disorder Do not typically seek treatment

Young Antisocial

21% of all alcoholics Middle 20s Over 50% have a family history of AUD Roughly half have a diagnosis of an Anti-Personality Disorder Higher rates of other conditions – anxiety, depression, bipolar disorder, etc. More than 75% smoke Over a third seek treatment


20% of all alcoholics One-third have a family history of AUD Middle-aged Well-educated Good income Relatively stable home life One-fourth struggle with major depression Half smoke

Intermediate Familial

19% of all alcoholics Middle-aged Half have a family history of AUD 50% have diagnosable depression 20% have bipolar disorder and/or obsessive-compulsive disorder One-fifth use cocaine and/or marijuana 25% will seek treatment

Chronic Severe

9% of all alcoholics Middle-aged Started drinking in their mid-teens 80% have a family history of AUD Greatest alcohol consumption of any subtype Drink an average of 248 days a year Binge-drink 69% of the time High rates of co-occurring disorders Most smoke Frequently abuse other substances Highest rate of divorce among subtypes – 25% Two-thirds will seek treatment In retrospect, it appears that Anthony Hopkins originally fit into the “Young Antisocial” subtype when his problem first surfaced. As his career blossomed, he eventually transitioned to the “Functional” subtype.×400.jpg

More about Functional Alcoholism

It was all that mad energy. I had an energy that ripped me apart and the booze was my way of dealing with that, but when you have all that energy you can just keep going; you don’t know when to stop.” ~ Anthony Hopkins Because he has had such a long and celebrated career, many people are surprised to learn that Hopkins was ever a problem drinker. This highlights the misconceptions held by the general public about the “typical” alcoholic. The stereotype envisioned by most people is of a “hopeless” drunk – disheveled, dirty, unemployed, homeless, etc. That is far from the truth. In fact, 75% of people who abuse alcohol or drugs ARE employed. Here’s the thing –AUD ignores boundaries of income, status, education, race, gender, and age. ANYONE can struggle with an addictive illness, including someone who appears otherwise successful. Right now, there are approximately 3.3 MILLION functional alcoholics in the United States.

Workaholism and Alcoholism

I worked harder than was necessary, really…I used to get to rehearsals three hours ahead of everyone else…so that I could beat everyone at the game.” ~Anthony Hopkins In the entertainment industry, Hopkins is well-known for his meticulous preparation for a role. He has stated that he will go over his lines hundreds of times in order to perfect a more natural-sounding delivery. And while learning his own part, he frequently memorizes everyone else’s lines, as well. Hopkins is also a prolific actor who eschews retirement and shows little signs of slowing down.    And although he has found new outlets for some of his excessive energy, he has demonstrated several of the signs of the workaholism common to many former active substance abusers. Upon regaining their sobriety, many ex-alcoholics/addicts find that they have an overabundance of time on their hands now that they are no longer constantly obsessing over, acquiring, using, or recovering from alcohol and drugs. Often, they will throw themselves into their work, rationalizing that at least they are putting their time and energy into something worthwhile. However, a problem arises for some people in recovery when they focus so much on their careers that their personal life suffers. For example:

  • Poor work-life balance – Hopkins has two failed marriages and has been estranged from his daughter for decades.
  • Social awkwardness and isolation – Hopkins is not known for socializing with the other members of the cast and crew. He has said, “I don’t have many friends; I’m very much a loner. As a child I was very isolated…”
  • Emotionally-distant –Hopkins admits that he finds it hard to relate to most people, saying, “… I’ve never been really close to anyone.”

Workaholism, while “productive” is ultimately unfulfilling. This explains why so many workaholics battle depression.

The Role That Narcissism Plays

I drank a lot, like a lot of actors did…I remember thinking, “Well this is the way to go. This is fantastic.”” ~Anthony Hopkins It’s not a surprise that most actors are at least somewhat narcissistic. After all, it takes a specific sort of personality to perform on stage in front of thousands of people or to act in a film that will be seen by millions. This is not a bad thing. However, when self-absorption is taken to the extreme, it can manifest as a condition known as Narcissistic Personality Disorder. This illness is characterized by:

  • Severe self-obsession
  • An extreme need for admiration and approval of others
  • Arrogance
  • Entitlement
  • Lack of empathy
  • Willingness to belittle or take advantage of others
  • Poor impulse control
  • Depression
  • Low self-esteem

Not surprisingly, almost two-thirds of those with NPD drink excessively or abuse drugs. On the flip side, 12% of people with a SUD have NPD. For comparison, the NPD rate among the general population is only around 6%.

Does Drinking REALLY Help Creativity?

And it’s great. For a while, it’s creative. It’s part of the Dionysian thing…It’s extraordinary creative power…The tragic thing is it’s got this scorpion’s tail. It finally turns around and bites you in the ass and kills you.” ~ Anthony Hopkins, Inside the Actor’s Studio Like a lot of creative people, Hopkins says his use of intoxicants helped him in his career. And, because drinking is relaxing and lowers inhibitions, there may be a small grain of truth to that idea. But alcohol abuse has the opposite effect:

  • Blackouts
  • Impulsivity
  • Memory loss
  • A reduction in brain volume
  • Shortened attention span
  • Confusion
  • Cognitive decline
  • Impaired problem-solving skills

In the end, alcoholism tends to destroy talent, rather than encourage it. For example, Billie Holiday, Sir Richard Burton, Dylan Thomas, Amy Winehouse, Truman Capote, Keith Whitley, and Hank Williams all died because of drinking, decades earlier than they should have. What else could they have gone on to create? The trade-off just doesn’t seem worth it. Sir Richard Burton once said he drank “to burn up the flatness, the stale, empty deadness that one feels when one goes offstage.”

Is There a Connection Between Asperger’s and AUD?

“Well, I’ve been diagnosed with Asperger’s, but I’m high end. A lot of people with Asperger’s are highly functional, but inconsistent. They have nervous ticks, nervous habits, inconsistently obsessive thinking…He put it back on the map that Asperger’s people tend to be creative or severely handicapped.” ~ Anthony Hopkins, speaking to the Desert Sun in 2017 Once thought of as an entirely distinct disorder, Asperger’s is now considered to be part of the autistic spectrum. People with this manifestation of autism are usually “high-functioning”, meaning they can hold jobs and fulfill everyday obligations. However, they also find it extremely difficult to connect with or relate to others on a personal level. They struggle with:

  • Holding conversations
  • Listening to others
  • Talking about topics that don’t involve their personal interests
  • Recognizing non-verbal clues from others—facial expressions, body language, etc.

There was formerly a school of thought purporting that people with Asperger’s aren’t really at heightened risk for addictive disorders, because they prefer extreme order and predictability, instead of the chaos and disorder that comes along with alcohol or drug abuse. However, recent research suggests that the obsessive nature of autistic disorders like Asperger’s can cause a person to engage in addictive behaviors. There are two main reasons for this. FIRST, they may self-medicate with alcohol, drugs, or certain behaviors to ease the loneliness and emotional pain resulting from a lack of attachment to others. By drinking or using, they can soothe mental pain, sedate anxiety, and boost euphoric feelings. SECOND, alcohol has a specific allure. Unlike street-level drugs, alcohol is easy to obtain at a regular place and at a predictable price, without having to find a dealer. In 2017, a Swedish study concluded that autistic people with average to higher-than-average IQs are twice as likely to become addicted to substances than their peers.×600.jpg

Hitting Rock Bottom

It was the loneliest Saturday night that I’ve ever spent, December 27th. I went down to the Beverly Glen market and I bought my bottle of tequila and orange juice and…I was going to drink myself into the ground or dead. I didn’t want to go on. I was so tired. I was so fed up with myself and sick. ~ Anthony Hopkins In some ways, Hopkins was lucky than most in terms of his battle with alcohol. He didn’t lose everything – his career, his reputation, his money. He never was committed against his will and he didn’t permanently ruin his health. He didn’t go to prison and he never killed anyone. But he did suffer. When his wife left him in large part because of his drinking, Hopkins not-so-ironically sought solace in the bottoms of liquor bottles. He tried to drown his sorrows – and himself – in a sea of alcohol. 15 years into his alcoholism, he was finally at the place where so many dipsomaniacs find themselves – alone, seemingly without hope. Emotionally, he was at his lowest, the point that people familiar with alcoholism call “rock bottom”.

What Made the Difference for Anthony Hopkins?

The thing that REALLY got to me, the thing that woke me up was that I could have killed somebody. I didn’t care in the end whether I was going to die or not…I couldn’t care less. But I could have killed somebody. That was that deep shame…That total madness of really driving blindfolded, in a blackout. And I said to this fellow, “I’m an alcoholic and I need help.”” ~ Anthony Hopkins, after discovering that he had driven while blackout drunk It was the blackout-drunk driving that had the biggest personal impact upon Hopkins’ mind. During this attempted-suicide-by-bender, Hopkins attended a party. But at some point that evening, he drove off—blind drunk—and abandoned his car in the middle of the street in front of his apartment. Then he went back to thee party and forgot all about it. His car remained back at home, radio blaring and lights on. In fact, when he tried to leave a second time and couldn’t find his car, he thought it had been stolen. When reminded of what he had done earlier, Hopkins was so stunned that he told his host that he was finished with drinking. That very night, they looked up the number of a local Alcoholics Anonymous chapter. Despite his self-professed shame, he was still extremely reluctant to actually go to a meeting. But go he did two days later, chaperoned by another member of AA. To his surprise, at his very first meeting, he saw another actor he had worked with in the past. Today, Hopkins says that everything he had been looking for his whole life he found that evening with AA. He says he had finally come home.

The Twelve Steps of Recovery

“…I realized this was the best thing that could have ever happened to a person like me…The most amazing education I’ve ever had…But it is like the kingdom, I guess, we’ve all been looking for, in peace, in spirit. I don’t understand it, because what I’ve put into this program and into this life is nothing compared to what I’ve got back.” ~ Anthony Hopkins Since 1935, Alcoholics Anonymous has been a mutual fellowship program created by alcoholics for alcoholics. It has two main goals – to help its members stay sober and to help other alcoholics become sober. To do this this, AA members are encouraged to participate in a 12 Step program:

  1. We admitted we were powerless over alcohol – that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory and when we were wrong promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

AA works so well because members can inspiration and strength from each other. Alcoholism is a lonely disease that isolates drinkers from everyone they care about, but people in AA learn that no matter what they have done or what they have gone through, they are not alone. This has been called the “kinship of common suffering”.×400.jpg

The Importance of a Higher Power

…I wanted SOMETHING—I wanted some help, I wanted some Power to come into my life. I knew that much. I didn’t know anything up here, but I knew something had to come into me to help me. Or something had to come out of me to help me…As I was walking back to my car, the most remarkable thing happened…A big voice said, “It’s all over. Now you can start living.” ~ Anthony Hopkins Hopkins was loath to accept the spiritual aspect of AA. As an agnostic, he half-considered the mention of “God” to be a “bad word”. In that respect, he was like many people new to AA—he didn’t want to have religion thrust in his face. But it’s important to understand that the 12 Steps do not require a belief in any sect’s specific concept of God. Rather, they ask us to turn our lives over to a God of our own understanding. Most AA members choose simply to refer to a “Higher Power”. But what does that mean, really? A Higher Power is anything outside of and greater than ourselves in which we can place our trust, especially as it pertains to recovery from alcoholism. While many interpret this as a deity, others may rely on love, medical science, humanity, or even the universe itself. The underlying philosophy is this—because the problem is bigger than we are, the solution must be as well. For his part, Hopkins is succinct and direct about what happened with him, saying, “I was hellbent on destruction. And I just asked for a little bit of help, and suddenly, pow. It was just like bingo.”

Carrying the Message to Others

“The thing with alcoholism is that it makes you very self-obsessed, it’s all ‘me, me, me’. Put 10 guys in a room and, by next week, maybe six will be gone. But I could tell Tony really wanted to stick with it. So, I told him if he really wanted to help himself, the only way to do it was to help others.” ~ Clancy Imislund, who helped Hopkins when the actor was new to AA The 12th Step involves assisting others with their recovery. Researchers at the University of Connecticut studied over 1700 participants in Alcoholics Anonymous who (a) became sponsors, (b) finished their 12th Step, or (c) did neither. After 90 days of rehab for alcoholic:

  • 40% of those who helped other people stayed sober for at least one year.
  • Just 22% of non-helpers stayed alcohol-free.

Significantly, even among those individuals who faced additional risk factors—AUD within the family, disability, learning difficulties, or a co-occurring mental disorder—helping others still provided benefits. According to a 2010 survey of over 4500 volunteers:

  • 77% said their emotional health improved
  • 73% reported decreased stress
  • 68% enjoyed better physical health
  • Almost ALL felt happier

Serving others seems to engage the same circuits in the brain that light up when parents care for their children. In mammals, this response provides a number of benefits.

  • Boosted immunity
  • Reduced stress
  • Fewer self-centered behaviors

The areas of the brain linked to selfish behavior or hoarding are also involved in addiction. This means that reducing self-absorbed feelings will also lessen cravings for alcohol. Additionally, research shows that helping other people prompts a release of dopamine. In other words, altruistic behavior is reinforced by a pleasurable reward. Simply put, it feels good to be of service.×400.jpg

Getting Professional Help for AUD

Although 12-Step fellowship can provide invaluable support to a struggling alcoholic, it is not substitute for specialized professional treatment. There is no cure for AUD, but as with other chronic diseases, the condition can be managed effectively. This involves:

  • Timely intervention – before the physical and mental damage becomes permanent
  • Evidenced-based treatment – tailored to the individual
  • Medication-Assisted Therapy (MAT) – using FDA-approved drugs to ease cravings and manage withdrawal symptoms
  • Lifestyle changes – engaging in behaviors that support sobriety
  • Strong support – from family and friends
  • Aftercare – long-term professional assistance

The “gold standard” of AUD treatment utilizes both counseling and MAT. Psychosocial:

  • Cognitive-Behavioral Therapy (CBT)– Offered as one-on-one counseling or peer group therapy
    • Identifying drinking triggers
    • Managing stress
    • Healthy thought processing
    • Coping skills
    • Relapse prevention and response
  • Motivational Enhancement Therapy
    • Motivation
    • Identifying negatives of drinking
    • Recovery planning
    • Confidence building
    • Sober living skills
  • Couples/Family Counseling
    • Education about AUD
    • Communication skills
    • Conflict resolution
    • Codependency and enabling
    • Parenting skills
    • Family response to relapse


  • Naltrexone—Reduces cravings by blocking the pleasurable effects of alcohol
  • Acamprosate—Stabilizes the chemical balance of the brain during alcohol withdrawal
  • Disulfiram/Antabuse—Aversion therapy drug that makes a person violently sick if they consume alcohol
  • Fluoxetine/Prozac—For co-occurring alcoholism and depression
  • Topiramate/Topamax – Increases average length of abstinence by reducing the frequency of drinking
  • Ondansetron/Zofran – Reduces drinking frequency and increases length of abstinence

The most successful recovery plans incorporate both formal treatment and 12-Step support.

What Can We Learn from Anthony Hopkins’ Story?

“Hi. I’m Tony, and I’m an alcoholic.” ~ Anthony Hopkins The biggest lesson we can glean from Anthony Hopkins is that ANYONE can develop AUD. Talent, success, and money do not protect against the disease of addiction. But Hopkins’ life also proves that ANYONE can recover, even after long-term alcohol abuse. To date, Hopkins has achieved nearly 43 years of sobriety, earned one day at a time. Finally, we see that there is hope, health, and happiness after alcoholism. Hopkins didn’t just regain his sobriety, he got back his life. And what wisdom would Anthony Hopkins give someone else battling an addiction or mental health disorder? “Accept life as it is. Just be grateful to be alive.”