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Updated on February 4, 2022

Alcohol Shakes or Tremors (Causes & Treatment)

What are Alcohol Shakes (Tremors)?

Alcohol shakes or tremors occur when a long-term and/or heavy drinker stops consuming alcohol.

Side effects vary from person to person. However, alcohol shakes are one of the most common symptoms of withdrawal and excessive alcohol consumption.

Alcohol Shakes or tremors:

  • Are rhythmic
  • Are uncontrollable
  • Tend to occur in the hands and fingers

Some people experience tremors in their heads, arms, eyes, and voice. Sometimes, pain or discomfort accompanies shaking.

These shakes can be so light they're barely noticeable. They can also be severe and interfere with normal functioning. Alcohol shakes aren't life-threatening.

Alcohol withdrawal can be fatal, though. It’s essential to seek medical attention during alcohol withdrawal, especially after heavy, long-term use.

Why am I Shaking with a Hangover?

Many people experience shaking when they're hungover.

Most often, shaking occurs because alcohol use has affected a person’s nervous system cells. Alcohol interferes with brain activity and causes a depressant effect. The brain grows used to lower levels of stimulation. 

When someone stops drinking, their brain is flooded with activity. The hyperactivity is stimulated.

This is what triggers tremors and shaking. The longer and more heavily someone drinks, the more frequent and severe the shaking.

Shaking during a hangover can be a sign of a serious medical condition. You should seek medical attention if you experience shaking as the effects of drinking alcohol wear off.

Symptoms of Alcohol Tremors

Body shakes are the most obvious symptoms of alcohol tremors. 

If you experience alcohol tremors, you can expect:

  • Shaking to begin about 24 to 72 hours after your last drink
  • Rhythmic shaking, most often in the hands
  • Shaky voice
  • Problems holding or controlling items

Tremors might be a sign of delirium tremens (DTs). DTs are a potentially fatal condition linked to alcohol withdrawal. The condition is rare but requires medical attention.3 

How Long Do Tremors Last? 

Tremors usually begin within 5 to 10 hours after someone’s last drink. They peak within 24 to 48 hours and gradually taper off. How long they last is different for each person. 

If you’ve recently stopped consuming alcohol and you experience shaking, it’s essential to seek medical attention to ensure the issue is not related to DTs.

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Causes of Alcohol Tremors

There are three possible causes of alcohol tremors.

They include:

1. Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms occur because the body becomes reliant on alcohol to function. When someone stops drinking, their body must adjust to functioning without alcohol.

Symptoms of alcohol withdrawal include:

  • Depression
  • Anxiety
  • Fatigue
  • Nightmares
  • Mood swings
  • Insomnia
  • Nausea and vomiting
  • Sweating
  • High blood pressure
  • Rapid heart rate
  • Headache
  • Hallucinations
  • Delirium tremens (DTs)

2. Alcohol-Related Brain Damage 

Alcohol-related brain damage (ARBD) or alcohol-related brain injury (ARBI) are brain disorders caused by long-term, heavy alcohol consumption. They usually affect people between the ages of 40 and 50.

Symptoms of ARBD and ARBI include small changes in a person’s ability to think or remember things. They might also experience mild cognitive impairment.

Continued drinking puts someone with ARBD or ARBI at risk for severe brain damage, including dementia.

3. Alcohol-Related Liver Disease

The liver is severely affected when someone consumes alcohol. It must work harder to rid the body of toxins like alcohol than it does other substances.

Binge drinking or heavy long-term drinking is especially damaging to the liver. 

Alcohol use triggers three alcohol-related liver diseases, including:

  • Fatty liver disease, an early stage of alcohol-related liver disease. It occurs when fat collects in the liver because the organ can't perform optimally. It has very few symptoms, but some people experience right-side discomfort.
  • Alcoholic hepatitis, which is inflammation of the liver. It occurs when there is cell death in the liver. About a third of all heavy drinkers develop this condition. Symptoms include fever, jaundice, nausea, vomiting, and abdominal pain.
  • Alcoholic cirrhosis is the most severe type of alcohol-related liver disease. It occurs when liver cells die and are replaced with scar tissue, drastically affecting liver functioning. It develops over time and is a life-threatening condition if someone continues drinking.

Are Tremors Always a Sign of Alcoholism? 

No. There are many different causes of tremors.

Even if a person is a heavy drinker, tremors alone don't guarantee the person has AUD. However, they're a symptom of the disorder when they occur with other signs of AUD.

Over time, heavy alcohol consumption causes problems within the brain. When someone drinks a lot and then stops drinking, the body must adjust. This triggers hyperactivity in the brain and nervous system, leading to shaking.

Alcohol shakes with other symptoms of withdrawal suggest a physical alcohol dependence.

Symptoms of Alcoholism

Symptoms of alcoholism or alcohol use disorder (AUD) include:

  • Drinking more than you intend to
  • Failure to cut back or eliminate alcohol consumption
  • Frequent periods being drunk or hungover
  • Obsession with drinking alcohol
  • Problems at work or school
  • Relationship problems linked to drinking
  • Spending more time drinking than doing things you once enjoyed
  • Engaging in risky behaviors because of drinking
  • Drinking despite feeling bad or damaging your health
  • Drinking more and more to experience the same effects
  • Experiencing withdrawal symptoms when you do not drink

Alcohol Shakes vs. Delirium Tremens (DTs) 

Alcohol shakes and delirium tremens (DTs) are not the same. However, they can co-occur.

Shaking is a common symptom of heavy alcohol consumption and withdrawal. DTs, on the other hand, is a rare condition that occurs in only about 10 percent of alcohol abuse cases.7

Tremors and shaking are symptoms of DTs.

When shaking occurs with the following, it could signify DTs:

  • Anxiety
  • Nausea
  • Vomiting
  • Insomnia
  • Hallucinations

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Treatment Options for Alcohol Tremors 

Alcohol withdrawal is most safely treated in a medically supervised environment. During this time, doctors monitor a person’s vital signs and address serious complications immediately. 

Medical supervision also includes an assessment of someone’s:

  • Electrolytes
  • Vitamin deficiencies
  • Overall bodily functions

During withdrawal, the initial phase of treatment includes:

  • IV fluids
  • Vitamin supplements
  • Medication

These treatments help with the following symptoms, and more:

  • Tremors
  • Seizures
  • Vomiting
  • Hallucinations

Several medications are available for treating alcohol shakes, including:

  • Primidone (Mysoline)
  • Propranolol (Inderal)

Surgical procedures such as deep brain stimulation and thalamotomy are recommended for treating alcohol tremors in the limbs. Surgery rarely cures head or vocal tremors. 

Trying to Get Rid of Alcohol Shakes Yourself

If you experience alcohol shakes, you may be on the path to more dangerous withdrawal symptoms. It isn't a good idea to try and get rid of alcohol shakes alone. They could lead to more severe mental and physical health issues.

There are methods you can take to reduce alcohol shakes. These include rehydrating and taking vitamins.

However, it's best to seek professional treatment to manage your withdrawal symptoms in most cases.

How To Reduce Alcohol Tremors in Recovering Alcoholics

There are many things recovering alcoholics can do to avoid tremors and reduce the risk of relapse, alongside medical support. For example:

1. Keep Up With Your Recovery Process

Committing to the alcohol recovery process is the best way to keep tremors at bay. Over time, your body adjusts to being alcohol-free, and you won’t experience withdrawal symptoms.

Not drinking breaks the cycle of consuming and withdrawing from alcohol. 

2. Build a Support Group

Friends and family are valuable tools for helping you stay alcohol-free and reducing tremors. The more time you spend with people who encourage your alcohol-free lifestyle, the better chance you’ll have of successful recovery.

3. Eat a Healthy Diet

Eating healthy plays a major role in a person’s successful recovery. When your body receives the nutrients it needs, it feels better, and you’re less tempted to drink. 

Consider a diet including the following healthy foods:

  • Vegetables
  • Fresh fruits
  • Whole grains

4. Stress Management

Managing stress helps you control feeling jittery and avoid alcohol.

There are many tools available for managing stress, including:

  • Meditation
  • Deep breathing exercises
  • Yoga
  • Physical exercises like dance, swimming, and cardiovascular activity

5. Keep Yourself Busy

Make sure there are plenty of activities you enjoy to help you avoid alcohol. Busy people are less tempted to drink.

6. Stay Hydrated

Alcohol shakes are reduced when you flush the toxins out of your system. Staying hydrated also helps you feel better, sleep better, and feel full without consuming too many calories.

7. Don’t Drink Caffeine

You’ll also want to eliminate foods and beverages that make you feel jittery. Caffeine is one of those substances.

Caffeine can make you feel shaky even if your body isn't reacting to a lack of alcohol.

8. Get Enough Sleep 

Lack of sleep makes you shaky. It also reduces your ability to function and make healthy choices.

Seven to nine hours of quality sleep is one of the most powerful tools you have to help you avoid alcohol shakes.

Treatment Options for Alcohol Abuse & Addiction

Here are some of the best treatments for AUD:

Inpatient Programs

Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days. They may be longer in some cases.

Throughout an inpatient program, you'll live on-site in a safe, substance-free environment. You'll go through medically supervised detox first, then behavioral therapy. Other services may be added to your regimen.

Many of these treatment programs assist you with an aftercare program afterward.

Partial Hospitalization Programs (PHPs)

PHPs are the second most intensive alcohol addiction programs. They're sometimes called intensive outpatient programs (IOPs). PHPs provide comparable services to inpatient programs.

These services may include:

  • Detox
  • Medical services
  • Behavioral therapy
  • Support groups
  • Other holistic or custom treatments

The main difference between PHPs and inpatient programs is that you return home and sleep at your house during a partial hospitalization program.

Some PHPs provide food and transportation. This varies by program.

PHPs are ideal for new patients and those who have completed an inpatient program and still require intensive treatment.

Outpatient Programs

Outpatient programs are less intensive than inpatient programs and PHPs. They're best for people who are highly motivated to achieve sobriety. Patients usually have responsibilities at work, home, or school.

These programs customize your treatment sessions around your schedule.

Outpatient programs may be part of aftercare once a patient completes an inpatient program or PHP.

Medication-Assisted Therapy (MAT)

Certain people qualify for medication-assisted therapy. Some medications can assist you throughout detox and withdrawal. Others can reduce cravings and normalize your bodily functions.

The most common medications used to treat AUD are:

  • Disulfiram (Antabuse)
  • Acamprosate (Campral)
  • Naltrexone (Revia and Vivitrol)

MAT can help prevent relapse and increase your chance of recovery if combined with other therapies.

Support Groups

Support groups are peer-led organizations made of people dedicated to helping each other stay sober. They can be the first step towards sobriety or part of an aftercare plan.

Many of these programs follow the 12-step approach.

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  1. “Alcohol-Related Brain Damage (ARBD): What Is It and Who Gets It?” Alzheimer’s Society
  2. “Chronic Alcoholic Liver Disease | Treatment, Signs, & Damage.”
  3. “Delirium Tremens (DTs): Practice Essentials, Background, Pathophysiology.” EMedicine, 8 Oct. 2020
  4. National Institute of Alcohol Abuse and Alcoholism. “Alcohol’s Effects on the Body.” National Institute on Alcohol Abuse and Alcoholism (NIAAA), 14 Sept. 2011
  5. Harvard Health Publishing. “Alcohol Withdrawal - Harvard Health.” Harvard Health, Harvard Health, 22 Apr. 2019
  6. Koller, W et al. “Tremor in chronic alcoholism.” Neurology vol. 35,11 : 1660-2
  7. Trevisan, L A et al. “Complications of alcohol withdrawal: pathophysiological insights.” Alcohol health and research world vol. 22,1 : 61-6.

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