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Updated on September 29, 2021

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, but shaking or alcohol shakes are one of the most common symptoms of withdrawal and excessive alcohol consumption.

Shakes or tremors are involuntary. They occur in various parts of the body. They are not life-threatening, but they can affect a person’s everyday functioning. Other aspects of withdrawal are potentially fatal, though. It’s important to seek medical attention during alcohol withdrawal, especially after heavy, long-term use.

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), a potentially fatal condition associated with alcohol withdrawal. The condition is rare but requires medical attention. 

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

3 Potential 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 serious brain damage, including dementia.

3. Alcohol-Related Liver Disease

The liver is severely affected when someone consumes alcohol. The liver 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 detrimental to the liver. 

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

  • Fatty liver disease, which is an early stage of alcohol-related liver disease. It occurs when fat accumulates in the liver because the organ is no longer able to 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 serious type of alcohol-related liver disease. It occurs when liver cells die and are replaced with scar tissue, drastically affecting the liver's functioning. It develops over time and is a life-threatening condition if someone continues drinking once it develops.

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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. 

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 do not guarantee the person has AUD. They are a symptom of the disorder, though, when they occur with other symptoms 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, which leads to shaking.

Alcohol shakes, when accompanied by other symptoms of withdrawal, indicate a physical alcohol dependence. It’s important to get medical attention to ensure the withdrawal process is safe.

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 or dangerous 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, but they can occur simultaneously. Shaking is a common symptom of heavy alcohol consumption and withdrawal. DTs, on the other hand, is a somewhat rare condition that occurs in only about 10 percent of alcohol abuse cases.

Shaking and tremors are symptoms of DTs. When shaking occurs in combination with anxiety, nausea, vomiting, insomnia, and hallucinations, it could signify DTs.

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Why am I Shaking with a Hangover?

Many people experience shaking when they are hungover. Shaking or tremors are rhythmic, uncontrollable, and tend to occur in the hands and fingers. Some people experience tremors in their head, arms, eyes, and voice. Shaking can be so light it’s barely noticeable, but it can also be severe and interfere with the ability to function normally.

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.

Sometimes, pain or discomfort accompanies shaking but not always.

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 accustomed to lower levels of stimulation. 

When someone stops drinking, their brain is flooded with activity and 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.

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 is not a good idea to try and get rid of alcohol shakes alone as they could lead to more severe mental and physical health issues.

While there are methods you can take to reduce alcohol shakes, including rehydrating and taking vitamins, in most cases, it is best to seek professional treatment to manage your withdrawal symptoms. Withdrawal symptoms could be life-threatening if not handled properly.

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, and overall bodily functions.

During withdrawal, the initial phase of treatment includes IV fluids, vitamin supplements, and medication to help with tremors, seizures, vomiting, hallucinations, and more.

Several medications are available for treating alcohol shakes, including Primidone (Mysoline) and Propranolol (Inderal).

In severe cases, 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. 

8 Additional Ways Recovering Alcoholics Can Reduce Tremors

There are many things recovering alcoholics can do to avoid tremors and reduce the risk of relapse. 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 symptoms of withdrawal. 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 a 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. 

Healthy foods like vegetables, fresh fruits, whole grains, and sufficient amounts of macronutrients give your body the foundation it needs to avoid unhealthy dietary decisions.

4. Stress Management

Managing stress helps you control feeling jittery and avoid alcohol. There are many tools available for helping you manage 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 at your disposal that help you avoid alcohol consumption. 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

In addition to adding healthy foods into your diet, you’ll also want to eliminate foods and beverages that make you feel jittery. Caffeine is one of those substances. It can make you feel shaky even if your body is not reacting to a lack of alcohol.

8. Get Good Sleep 

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

  • Inpatient Programs — Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days, however they may be longer in certain cases. Throughout the duration of an inpatient program you will live on site in a safe, substance-free environment. You will go through medically supervised detoxification first, then behavioral therapy and other services will be added to your regimen. Many of these treatment programs will assist you with an aftercare program afterwards.
  • Partial Hospitalization Programs (PHPs) PHPs are the second most intensive alcohol addiction programs. They are sometimes referred to as intensive outpatient programs (IOPs). Partial hospitalization programs provide comparable services to inpatient programs. These may include detoxification, medical services, behavioral therapy, support groups, and other holistic or custom treatments. The main difference between PHPs and inpatient programs is that in a partial hospitalization program, you return home and sleep at your house. Some PHPs provide food and transportation, but this varies by program. PHPs are ideal for new patients, as well as patients who have completed an inpatient program and still require intensive treatment.
  • Outpatient Programs Outpatient programs are less intensive than inpatient programs and PHPs. They are best for people who are highly motivated to achieve sobriety and have responsibilities at work, home, or school. Outpatient treatment programs customize your treatment sessions around your personal schedule. Outpatient programs can help new patients achieve success. They may also be a part of aftercare programs once a patient completes an inpatient program or PHP.
  • Medication-Assisted Therapy (MAT) Certain patients will qualify for medication-assisted therapy. Some medications can assist you throughout detoxification and withdrawal. Others can reduce cravings and normalize your bodily functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone (Revia and Vivitrol) are the most common medications used to treat Alcohol Use Disorder. 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 a first step towards sobriety or a component of an aftercare plan. Many of these programs follow the 12-step approach.

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“Alcohol-Related Brain Damage (ARBD): What Is It and Who Gets It?” Alzheimer’s Society

“Chronic Alcoholic Liver Disease | Treatment, Signs, & Damage.”

“Delirium Tremens (DTs): Practice Essentials, Background, Pathophysiology.” EMedicine, 8 Oct. 2020

National Institute of Alcohol Abuse and Alcoholism. “Alcohol’s Effects on the Body.” National Institute on Alcohol Abuse and Alcoholism (NIAAA), 14 Sept. 2011

Harvard Health Publishing. “Alcohol Withdrawal - Harvard Health.” Harvard Health, Harvard Health, 22 Apr. 2019

“You’re Wrong about Alcohol Withdrawal.”, 18 Apr. 2019

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