Does Alcohol Withdrawal Cause Shakes?

Robert Gerchalk

Robert is our health care professional reviewer of this website. He worked for many years in mental health and substance abuse facilities in Florida, as well as in home health (medical and psychiatric), and took care of people with medical and addictions problems at The Johns Hopkins Hospital in Baltimore. He has a nursing and business/technology degrees from The Johns Hopkins University.

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Alcohol Detox Shakes

You may have heard about the “shakes” or tremors often associated with alcohol withdrawal. It’s a symptom that’s frequently mentioned in discussions about addiction recovery, depicted in media, and perhaps even witnessed in the lives of those around you. This phenomenon, while widely recognized, is just the tip of the iceberg when it comes to understanding the complexities of alcohol withdrawal.

Alcohol withdrawal is a multifaceted process, encompassing a range of physical and emotional experiences far beyond just the shakes. It’s a journey that tests the limits of human endurance and resilience, and understanding it in its entirety is crucial for anyone standing at the threshold of recovery.

This article aims not just to enlighten you about the shakes but to offer a comprehensive view of the entire alcohol withdrawal process. It’s an intricate, deeply personal experience, yet one that resonates with millions worldwide.

While the shakes might be a common and visible sign of alcohol withdrawal, it is just one aspect of a much larger picture. 

Embarking on the Journey of Recovery: Understanding Alcohol Withdrawal

When your body adapts to the consistent presence of a substance like alcohol, suddenly stopping it can trigger a cascade of withdrawal symptoms. Confronting alcohol addiction often leads to this first significant obstacle: alcohol withdrawal. This phase unfolds when you make the bold decision to cut down or cease your prolonged and heavy alcohol consumption. 

Navigating through this period can be a formidable challenge since it’s characterized by a spectrum of symptoms. Among these, the ‘shakes’ or tremors stand out as particularly prominent. Gaining a deeper understanding of these symptoms — their origins, their implications, and effective management strategies — is crucial. This knowledge not only prepares you for what lies ahead but also paves the way for a more manageable and less daunting journey through this critical stage of recovery.

Understanding the potential challenges of withdrawal is a vital step in taking control of your treatment and recovery process. 

Defining Alcohol Withdrawal

Alcohol withdrawal is a series of physical and emotional symptoms that occur when someone accustomed to heavy drinking suddenly stops or significantly reduces their alcohol intake. These symptoms are the result of your body adjusting to the absence of alcohol, a substance it has grown dependent on. The range of symptoms can be wide and varies greatly from person to person, influenced by factors such as the length and intensity of alcohol use, your general health, and your physiology.

Underlying Mechanisms of Alcohol Withdrawal

Regular and heavy consumption of alcohol alters the way your brain functions. Alcohol acts as a depressant on the central nervous system, slowing down brain activity. Over time, your brain adjusts to this depressant effect, leading to an increased tolerance to alcohol and a physical dependence on it. When alcohol is suddenly removed, your brain remains in a hyperactive state for a period, leading to withdrawal symptoms. These symptoms are a direct result of your brain and body trying to recalibrate and function normally without alcohol.

Symptoms of Alcohol Withdrawal

The symptoms of alcohol withdrawal can start as early as a few hours after your last drink and may last for weeks, with the intensity and duration varying significantly from person to person.

The withdrawal process typically follows a general timeline. The early stage, which can start within hours of your last drink, often includes symptoms like anxiety, shakes, and insomnia. As the withdrawal progresses, these symptoms may peak – often within the first 24 to 48 hours – and then will begin to diminish over the following days.

In some people, as the withdrawal process continues, symptoms can worsen and develop into more severe symptoms, such as delirium tremens, hallucinations, and seizures. It’s crucial to be aware of these symptoms and to understand that they are a normal part of the withdrawal process.

Why Does Alcohol Withdrawal Cause Shakes?

You’re probably wondering about the shakes because they’re one of the most commonly reported symptoms of alcohol control. The “shakes,” commonly experienced during alcohol withdrawal, are formally known as tremors. They are one of the most recognizable and often one of the earliest symptoms of alcohol withdrawal. The reason for the shakes lies in the brain’s chemistry. 

Nature of Tremors

Tremors or shakes during alcohol withdrawal are involuntary, rhythmic muscle contractions leading to shaking movements in one or more parts of the body. They most commonly affect the hands, but they can also occur in the arms, head, and even the voice.


When individuals have been consuming alcohol heavily and regularly stop drinking or significantly reduce their intake, their body undergoes withdrawal. Alcohol has depressant effects on the central nervous system (CNS). Over time, the CNS adapts to the constant presence of alcohol. Once the alcohol is removed, the CNS becomes hyperactive, which can show up as tremors.


Alcohol affects neurotransmitter systems in the brain, particularly gamma-aminobutyric acid (GABA) and glutamate. GABA has inhibitory effects, and glutamate is excitatory. Chronic alcohol use suppresses GABA activity and increases glutamate activity. When alcohol is withdrawn, there’s an imbalance with decreased inhibitory GABA activity and a relative excess of excitatory neurotransmitter activity, leading to neurological hyperexcitability that manifests as shakes.


These tremors typically begin within 5 to 10 hours after the last drink and can worsen over 48 to 72 hours. They may be accompanied by other symptoms of withdrawal such as anxiety, sweating, nausea, and insomnia.


The severity of the shakes can vary. For some, they may be relatively mild, but for others, they can be severe and debilitating. In severe cases, especially in the context of a more serious withdrawal syndrome known as Delirium Tremens (DTs), these tremors can be part of a life-threatening condition requiring immediate medical attention.


Treatment for the shakes in alcohol withdrawal often involves the use of medications, such as benzodiazepines, which can help reduce the severity of symptoms. In addition, medical supervision is important because withdrawal symptoms can indicate more serious underlying health issues and may necessitate further medical intervention.


It’s important to note that while the shakes are a distressing symptom, they are a sign that the body is attempting to readjust to the absence of alcohol. With proper medical care and support, individuals can successfully manage these symptoms and progress in their recovery journeys.

What to Expect During Withdrawal

Alongside tremors, you may experience a range of withdrawal symptoms that include but are not limited to anxiety, nausea, vomiting, sweating, irritability, and insomnia. These symptoms can range from mild to severe and are part of your body’s natural response to the absence of alcohol.

Severe Symptoms: Understanding Delirium Tremens

Symptoms of DTs include severe confusion, fever, hallucinations, and seizures. If you or your loved one experiences DTs, it’s critical to seek medical attention immediately as it requires urgent care.

You’re Not Alone

Knowing that you’re not alone in experiencing alcohol withdrawal can be comforting. A significant number of individuals who stop or reduce heavy alcohol use go through withdrawal symptoms. These statistics are a testament to the fact that withdrawal is a common and expected part of the recovery process. It’s a shared experience for many on the path to overcoming alcohol addiction, and there are numerous resources and support systems available to help you through it.

Finding Your Path to Recovery

Dealing with alcohol withdrawal can be challenging, but it’s a vital step towards reclaiming your health and well-being. The approach to managing withdrawal symptoms varies depending on their severity. For some, outpatient treatment with medication to ease symptoms might be sufficient. Others may require inpatient treatment, especially if you’re experiencing severe symptoms like DTs. It’s important to remember that seeking professional help is a crucial part of this process.

Support and Treatment Options

There are various support and treatment options available to help you through alcohol withdrawal. These range from medication to managing symptoms with the help of healthcare professionals to comprehensive care in a specialized facility. Professional treatment providers play a crucial role in ensuring your safety and comfort during withdrawal. They offer both medical care and emotional support, which are essential in navigating this challenging phase.

The Role of Treatment Providers

As you navigate through the challenges of alcohol withdrawal, it’s important to remember that you don’t have to go through it alone. Healthcare professionals, including doctors, nurses, and therapists, can provide the necessary support, medication, and therapy to help you get through this time safely. They’re trained to understand what you’re going through and can offer the treatment and guidance you need.

Detoxification and Medical Intervention

Detoxification is often the first step in treating alcohol withdrawal and is best managed under medical supervision. This can provide a safe environment to manage the shakes and other symptoms, often with the help of medications that can ease discomfort and reduce the risk of more serious complications.

Inpatient and Outpatient Programs

For managing withdrawal, you’ll find a variety of treatment options, including both inpatient and outpatient programs. Inpatient treatment involves staying at a residential facility and can provide a higher level of care, which may be necessary for those with severe symptoms or a history of complicated withdrawal. Outpatient treatment allows you to live at home while receiving regular medical care and support. This option can be suitable = for those with milder symptoms or extensive support networks.

Therapies and Supportive Care

As part of both inpatient and outpatient programs, you’ll have access to various therapies that can aid in managing withdrawal symptoms and addressing the root causes of addiction. These therapies might include cognitive behavioral therapy (CBT), which helps in identifying and changing negative thought patterns, and medication-assisted treatment (MAT), which can help ease cravings and withdrawal symptoms. Support groups and peer support are also integral to recovery, as well, providing a community of individuals who understand what you’re going through and can offer encouragement and advice.

Building a Foundation for a Sober Life

Recovery from alcohol use is a journey that extends far beyond the initial detoxification. It’s about crafting a new, fulfilling life where sobriety takes center stage. This involves laying down a strong foundation through various forms of therapy, support networks, and lifestyle changes. Long-term recovery is about more than abstaining from alcohol; it’s about creating a life where you no longer feel the need or desire to drink.

Strategies for Sustaining Sobriety

For many, sustaining sobriety involves regular attendance at support groups, like Alcoholics Anonymous or SMART Recovery, where the camaraderie of fellow members encourages ongoing commitment. Engaging in therapy can also provide a space to explore the underlying issues that may have contributed to alcohol use and to develop new coping strategies.

Developing a Relapse Prevention Plan

Relapse can be a part of the recovery journey, but with a solid prevention plan, it’s less likely. This plan should identify triggers, outline strategies to manage cravings, and include a support system you can rely on. Whether it’s a trusted friend, family member, or a professional counselor, having someone to turn to can make all the difference.

Alcohol Awareness

Over 1.4 million people sought treatment for alcohol addiction in 2021. Facing alcohol withdrawal is a significant step in your journey towards recovery. It’s a path marked by challenges, but also by hope and the possibility of a healthier future. Remember, every step you take, no matter how small, is a step towards a better life. 

Alcohol withdrawal, including the shakes, can be a daunting part of recovery. However, with understanding, proper treatment, and support, these challenges can be managed effectively. Call Alcohol Awareness at our 24/7 alcohol hotline. We can offer support and put you in touch with healthcare professionals and support networks. Taking this step is a courageous move towards a brighter, alcohol-free future. Remember, recovery is a journey, and every step forward is a step towards reclaiming your life.