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Hazardous drinking can cause an array of adverse health effects, and while some will brew under the surface for many years, others will be immediately obvious. Of these, physical conditions such as alcohol shakes and tremors are as noticeable as they are distressing: often providing the catalyst for individuals to seek out treatment options.
Also referred to as “jitters”, alcohol tremors are bodily shakes that often occur when someone struggling with alcohol consumption has suddenly stopped drinking. While they usually affect the hands, these bursts of involuntary shaking can also spread to someone’s arms, legs, and entire body.
As many victims will know, these symptoms can be embarrassing, inconvenient, and impede daily functioning. Trembling hands, for example, can make it difficult to perform daily tasks with accuracy such as dressing oneself or eating.
Another cause for concern can be how long these shakes and tremors last: which is often dependent on several factors. These range from overall physical health, genetic predispositions and most importantly, the individual’s unique alcohol intake.
Because “the shakes” may begin between 5-10 hours post-alcohol consumption, someone who is used to drinking large amounts daily may wake up each morning already experiencing tremors. These individuals may need a morning alcoholic drink, also known as an “eye-opener” just to steady themselves.
While each individual differs slightly in their experience of alcohol shakes and tremors, certain patterns have been noted. Typically, tremors will peak in the first 1-3 days after an individual’s last drink and may last for a further two months in severe cases.
Experiencing periods of shakiness and tremors can be inconvenient, to say the least, but understanding the basic science behind it can help individuals gauge when they should seek professional help. Gaining more information can also help differentiate between dependency-based alcohol shakes, and isolated post-binge drinking tremors referred to as “hangover shakes”.
In essence, shakes and tremors occur when the part of your brain that controls muscle function reacts to the alcohol leaving your system. These areas of the brain are referred to as the cerebellum and motor cortex.
Regularly drinking alcohol changes how neurotransmitters operate in the brain. Because it’s a depressant, alcohol will slow down parts of the brain mentioned above while interfering with mood-regulating chemical production.
As a result, the brain of a heavy drinker becomes accustomed to the sedative effects of alcohol and reduced levels of stimulation. Someone who drinks regularly can keep their brain working on an even keel despite other increasingly obvious health effects.
It’s when they stop drinking suddenly that problems arise.
When alcohol leaves the system, the brain must suddenly get used to an influx of activity as the nervous system becomes hyperactive. This is because prior, long-term drinking interferes with your body’s ability to regulate gamma-Aminobutyric acid (GABA) and glutamate.
These two important brain chemicals operate in opposing ways to reach a state of balance, with GABA calming the brain cells that glutamate excites. Therefore, the effects of GABA must be enhanced to match the quantity of alcohol that is consumed over time.
However, because alcohol acts as a depressant and reduces brain activity, neurotransmitter cells become sensitive to the glutamate produced.
When an individual stops drinking alcohol suddenly, their brain will become overstimulated in response to the glutamate produced, and there simply isn’t enough GABA to counteract it.
The resulting struggle as neurotransmitters attempt to achieve a state of equilibrium leads to symptoms of alcohol withdrawal: including alcohol shakes and tremors.
With this in mind, while many people feel shaky after a night of heavy drinking, this will soon pass as they re-enter a period of sobriety. If you find yourself drinking frequently and experiencing these shakes every time you try to go stop drinking, this could be symptomatic of a more severe form of alcohol withdrawal and by extension, Alcohol Use Disorder (AUD).
Moreover, experiencing shakes and tremors can be an early warning sign of Delirium Tremens (DT): one of the most serious complications of excessive alcohol consumption that can take days to manifest.
Someone who is at risk of developing this condition may experience nausea and vomiting, irregular heartbeat, vivid hallucinations, excessive sweating, and tremors.
In addition to the distressing mental symptoms of Delirium Tremens (delusions, hallucinations, anxiety), individuals with a history of chronic alcohol intake may also be at risk of developing seizures. Often mistaken for epilepsy, these symptoms can be fatal if medical attention isn’t received at a specialised alcohol rehab centre.
Furthermore, alcohol shakes and tremors (alongside other alcohol withdrawal symptoms) can be a sign of Wernicke-Korsakoff Syndrome (WKS), a severe condition linked to alcohol intake affecting the victim’s ability to think, move, and see. To prevent WKS from inflicting lifelong changes or becoming fatal, immediate medical care is required.
In sum, experiencing types of tremors after a rare bout of drinking probably isn’t anything to worry about, and will often subside unaided as the hangover fades. However, post-alcohol shaking, especially if encountered frequently alongside regular drinking, can be a sign of alcohol withdrawal and addiction.
Unsure of how else to manage, individuals experiencing alcohol shakes and tremors when they’re attempting to self-detox often start drinking alcohol again simply to alleviate the physical discomfort.
While this provides temporary relief, it perpetuates a worrying cycle of alcohol abuse and dependence that makes it increasingly hard to quit drinking.
Moreover, continuing to drink will simply bury the root cause of the problem while increasing the risk of neurological disorders, physical dependence, and more severe tremors. In an attempt to avoid withdrawal symptoms, returning to alcohol might also increase the likelihood of alcohol poisoning, especially as your tolerance increases.
Fortunately, a range of both medical and holistic treatments exist, both for alcohol shakes and the underlying dependency at its root. Receiving a medicated detox while supervised by a medical professional can help to mitigate alcohol tremors and prevent future symptoms of chronic or long-term alcohol abuse.
Professionals at rehab clinics take into account the amounts of alcohol present in someone’s system and any underlying health conditions to build a treatment plan. This will consist of prescription medications, lifestyle counselling, behavioural therapies and more.
Because alcohol shakes and tremors often occur in chronic drinkers as part of a larger addiction problem, other withdrawal symptoms may follow without proper assistance. Alongside bouts of shaking, those affected may also experience vomiting episodes, profuse sweating, heart palpitations, agitation, and anxiety.
By undertaking detox as an inpatient in a specialised clinic, you’ll be able to slowly reduce your alcohol intake in a way that is safe and comfortable. During a medicated detox, patients stay overnight at the rehab centre of their choosing to ensure they remain at ease and are away from alcohol temptations in the wider world.
Working alongside a team of professionals means you gain both treat your alcohol shakes and tremors while gaining insight into the reasons they might be happening. Treatment at a rehab clinic also ensures that patients are cared for according to their unique needs.
For example, some individuals may find that their alcohol shakes and tremors stop without medication: instead requiring a safe, holistically supported environment in which to detox from alcohol.
On the other side of the coin, some people will undergo a variety of additional withdrawal symptoms and may need prescription medications to prevent delirium tremens.
While no medications exist exclusively for the treatment of alcohol withdrawal or AUD, various prescriptions can be used to tackle alcohol shakes and other withdrawal symptoms. Any medication that you receive during alcohol detox will be tailored to your personal needs and will reflect the bespoke nature of your ongoing treatment plan.
Oftentimes, Benzodiazepines such as Valium or Lorazepam are administered to reduce alcohol-related shaking and are also useful in treating insomnia, anxiety, and nausea. Adrenergics may also be prescribed to help mitigate further tremors while also alleviating night sweats, rapid heartbeat, and arrhythmia.
In addition to these, beta-blockers such as Propranolol can be used to reduce blood pressure and increase circulation. These medications can also steady the raised heart rate that often exacerbates alcohol-related shakes by ensuring blood vessels are properly dilated.
While accepting medication during detox will treat alcohol-related shakes in the short term, this is a temporary solution. Individuals must form an actionable plan to successfully quit drinking and thereby prevent future cases of withdrawal.
Oftentimes, and especially in cases of severe AUD, clinicians will recommend committing to a residential rehabilitation programme. For around 28 days or longer, patients will progress through a recovery plan specifically designed to treat their unique alcohol dependency.
In addition to behavioural interventions, counselling, and 12-step support, you’ll receive holistic therapies to help cultivate lifestyle changes that will keep you alcohol-free. Inpatient programmes are considered the best way to achieve long-term recovery and prevent relapse as they allow subjects to fully focus on their sobriety without exterior distractions.
This means you’ll remain living at home while progressing through therapies to help curb your addiction and therefore avoid future instances of alcohol shakes and tremors, alongside other symptoms.
If you’re reading this article, the chances are you’ve experienced alcohol shakes and tremors for yourself, or have noticed these symptoms in someone dear to you. Whichever situation you find yourself in, there are a variety of ways that you can pave the way towards receiving help.
Clinicians and GPs use a variety of methods: including self-assessments and diagnostic tools to diagnose a patient, many of which you can access before your appointment. The first step towards addiction treatment is to ascertain someone’s severity using a clinical guideline.
Of these, the most accessible is the NHS clinical reference for problematic drinking. Updated in 2019, this comprehensive drinking guide helps readers identify hazardous patterns of excessive drinking and quantify their consumption.
The guideline states that individuals drinking more than 14 alcohol units per week may be harbouring a diagnosable addiction or dependency. Within their advice, the NHS provide everyday examples of these measures. For instance, one unit of alcohol roughly equates to half a pint of lager or a 125ml glass of wine.
One example is The CAGE Questionnaire: a preliminary test used to expose potential alcohol use disorders, with advice coming straight from healthcare providers.
This assessment consists of just four, clinically designed questions and can be completed in 10 minutes or less. As such, this initial screening tool is a popular strategy for both on-site diagnoses and individuals to understand their AUD risk at home.
However, while CAGE can be utilised outside of a doctor’s office, respondents should seek the advice of a qualified healthcare provider nonetheless.
Each question is designed to be less obtrusive than simply asking an individual if they consider themselves to have an alcohol problem. Instead, it isolates four principal elements of alcohol addiction, with the name CAGE being an acronym for Cut-down, Annoyed, Guilty, and Eye-opener.
Respondents accessing CAGE will therefore experience the following questions:
Based on how many of the CAGE questions they respond “yes” or “no” to, individuals will be able to tell how severe their potential alcohol dependency is. Upon completion, they’ll be given a score from one to four based on how many questions they responded “yes” to.
As such, receiving a score of 1 isn’t deemed significant, while a result of 4 indicates the need to start a detoxification process.
If you’re growing concerned about the frequency or severity of alcohol shakes and tremors, you don’t have to go through it alone. Here at Rehab 4 Alcoholism, our expert advisors will sympathetically assess your situation and tell you whether you should consider seeking professional help.
Whether you’ve just started experiencing alcohol shakes and tremors, have been plagued by these symptoms for years, or have noticed signs in a loved one, our team are here to help.
By performing a consultation, we can gauge the severity of your situation and help you plan ways to reclaim your life from the distressing symptoms of alcohol overuse.
By simply calling 0800 111 4108, you’ll be put straight through to our 24-hour helpline and be one step closer to receiving your free consultation. During the 10-25 minute assessment, one of our addiction psychiatrists will ask you questions about your alcohol intake, mental well-being, and physical health.
From here, they can assist you in selecting treatment options that are specifically designed with your well-being and future recovery in mind. This could be in the form of an immediate medicated detox, residential care, outpatient treatment, or access to local fellowship groups such as Alcoholics Anonymous.
 Alcohol Withdrawal Symptoms: A Quick Aid to Safe and Smooth Recovery from Alcohol and Alcoholism Withdrawal Symptoms https://www.google.co.uk/books/edition/Alcohol_Withdrawal_Symptoms/3NBkuQEACAAJ?hl=en
 Dynamic Pathways to Recovery from Alcohol Use Disorder: Meaning and Methods https://www.google.co.uk/books/edition/Dynamic_Pathways_to_Recovery_from_Alcoho/rA9NEAAAQBAJ?hl=en&gbpv=0
 The Science of Drinking: How Alcohol Affects Your Body and Mind https://www.google.co.uk/books/edition/The_Science_of_Drinking/iJhPpwAACAAJ?hl=en
 Neurobiology of Alcohol and the Brain https://books.google.co.th/books?id=QcDvDwAAQBAJ&printsec=frontcover&dq=alcohol+addiction&hl=en&sa=X&ved=2ahUKEwjA15LAq7f5AhUY6jgGHcjxDBgQ6AF6BAgIEAI#v=onepage&q=alcohol%20addiction&f=false
 Never Enough: The Neuroscience and Experience of Addiction https://www.google.co.uk/books/edition/Never_Enough/ociODwAAQBAJ?hl=en&gbpv=0
 Rehab 4 Alcoholism: What is Alcohol Addiction? https://www.rehab4alcoholism.com/alcohol-addiction
 The Addiction Solution: Unravelling the Mysteries of Addiction Through Cutting-Edge Brain Sciencehttps://books.google.co.th/books?id=_HlQfxWyJogC&printsec=frontcover&dq=valium+addiction&hl=en&sa=X&redir_esc=y#v=onepage&q=valium%20addiction&f=false
 Wernicke–Korsakoff syndrome https://www.alzheimers.org.uk/about-dementia/types-dementia/wernicke-korsakoff-syndrome
 Dynamic Pathways to Recovery from Alcohol Use Disorder: Meaning and Methods https://books.google.co.th/books?id=rA9NEAAAQBAJ&printsec=frontcover&dq=alcohol+use+disorder&hl=en&sa=X&ved=2ahUKEwiR0MKsrLf5AhWT3jgGHaDmAb0Q6AF6BAgCEAI#v=onepage&q=alcohol%20use%20disorder&f=false
 Rehab 4 Alcoholism: Alcohol Withdrawal Symptoms https://www.rehab4alcoholism.com/alcohol-treatments/alcohol-detox/withdrawal-symptoms
 The Addiction Solution: Unravelling the Mysteries of Addiction Through Cutting-Edge Brain Science https://books.google.co.th/books?id=_HlQfxWyJogC&printsec=frontcover&dq=valium+addiction&hl=en&sa=X&redir_esc=y#v=onepage&q=valium%20addiction&f=false
 Rehab 4 Alcoholism: Alcohol Detox Centres https://www.rehab4alcoholism.com/alcohol-treatments/alcohol-detox
 Alcohol Detox: The Guide to Safely Clean Up Your Lifestyle, Detoxify & Maintain Healthy Body Without Drugs https://www.google.co.uk/books/edition/Alcohol_Detox/JrLpzgEACAAJ?hl=en
 A Prescription for Alcoholics: Medications for Alcoholism Medication Assisted Treatment with Acamprosate, Baclofen, Topiramate, Naltrexone, Nalmefene and More https://www.google.co.uk/books/edition/A_Prescription_for_Alcoholics_Medication/DxItjwEACAAJ?hl=en
 Rehab 4 Alcoholism: Admission To Alcohol Rehab https://www.rehab4alcoholism.com/alcohol-treatments/alcohol-rehab/admissions
 Alcoholics Anonymous https://www.aa.org/
 Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5 https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-use-disorder-comparison-between-dsm
 Alcohol Advice https://www.nhs.uk/live-well/alcohol-advice/
 The CAGE questionnaire for alcohol misuse: a review of reliability and validity studies https://pubmed.ncbi.nlm.nih.gov/17716538/
 Rehab 4 Alcoholism: Finding a Drug and Alcohol Rehab in Your Local Area https://www.rehab4alcoholism.com/rehab-locator
 Rehab 4 Alcoholism: Contact Us https://www.rehab4alcoholism.com/contact
Alcoholism, also known as alcohol addiction or an alcohol use disorder (AUD), is a disorder which can affect all individuals, no matter their cultural or social background. This is because …