Does Alcohol Withdrawal Cause Tremors?

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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A Closer Look at the Connection Between Alcohol Withdrawal and Tremors

Alcohol use disorder (AUD) is a prevalent medical disease characterized by the compulsion toward and inability to control alcohol use despite the adverse health and social consequences. Sometimes referred to as alcohol dependence or alcoholism, AUD can assume multiple forms, from mild to severe. 

Long-term, excessive alcohol use can result in significant changes to brain function that often perpetuate the disease while making those struggling with AUD more susceptible to relapse. Fortunately, even the most severe cases are resolvable through a combination of behavioral therapies, mutual support groups, and medications. 

Once alcohol dependency forms, however, withdrawal symptoms can be dangerous and even life-threatening. People in the advanced stages of AUD may experience constant or intermittent tremors and involuntary shaking in one or more parts of the body. 

What Are Tremors?

A person experiences bodily tremors when the muscles contract uncontrollably in a rhythmic fashion. The experience usually results in visible shaking in at least one part of the body. The episodes occur quickly in intervals between six and 10 seconds. Tremors are associated with a disruption in brain activity that controls the body’s muscles. 

Not all tremors are associated with alcohol. The most common form of tremors comes from a response to cold weather, which creates intermittent rippling movements throughout the body. The body’s muscles contract to burn energy and generate more heat. 

Tremors and Alcohol Withdrawal

Alcohol is a depressant, which means that the drug slows areas of the brain that control mood-regulating chemicals. Frequent drinkers will become accustomed to reduced stimulation levels as they build up a tolerance for alcohol. 

When someone who is afflicted with AUD or who has recently gone on an extended drinking binge abruptly stops consuming alcohol, the brain will quickly find itself inundated with more activity. In turn, the nervous system goes into a hyperactive state. This is where the withdrawal symptoms set in and people start experiencing tremors and alcoholic shakes. 

For some alcohol users, this condition can occur as quickly as eight hours after the last drinking episode. Even recreational drinkers can experience these symptoms after consuming large quantities of alcohol in a single session. This condition is sometimes called “hangover shakes,” a state in which non-dependent drinkers who have recently misused alcohol experience shaking in their hands or throughout other parts of the body. 

For those who drink regularly, tremors after cessation are a clear indicator that the individual has developed a physical dependency on alcohol. People experience tremors because their body has come to expect specific levels of alcohol to be carried through their bloodstream and into their veins where it distributes the substance through the body’s entire circulation system.

Alcohol Withdrawal and the Central Nervous System

Problematic drinking has several dire implications for the body’s central nervous system (CNS). But how exactly does this work? Foremost, alcohol mediates activities on a diverse range of neurotransmitters. It’s this assemblage of transmitters that accounts for the physiological impacts of all drugs, including prescription medications. 

Acute alcohol intoxication usually starts with symptoms of drowsiness and a visual loss of control of their normal motor functions. Cases of extreme intoxication can result in coma and even death. 

This happens when alcohol causes the body to depress its tendon reflexes, and drinkers begin experiencing some combination of hypotension or hypothermia before their respiratory functions slow and they fall unconscious. These situations may require urgent hospitalization to prevent irreversible injury to the brain while in the non-responsive state.

People who drink daily or frequently engage in binge drinking sessions in which they consume excessively high levels of alcohol can easily find themselves physically dependent on alcohol. Moreover, determining who needs a medically assisted withdrawal detoxification treatment can be a challenge for clinicians since these requirements vary from person to person. 

As a rule, men who consume more than 15 drinks a week, women who drink more than eight, and anyone who drank heavily in 5 of the last 30 days are considered heavy alcohol users. Those who fall into this category are at high risk of dependency and may need a medically assisted detoxification treatment program to stop using alcohol safely. 

Frequent or heavy drinking over time induces specific brain adaptations that increase NMDA receptor levels. These receptors control the excitatory portions of the brain system. Once a problematic drinker stops using alcohol, the excess receptors will coalesce, creating a calcium influx into the brain cells that can cause hyperexcitability, or tremors, while simultaneously destroying the cells. 

When this happens, drinkers who have developed a dependency on alcohol can experience a diverse range of symptoms, including mild sleep disturbances and even delirium. Some people become weak and mentally confused in the days after they stop drinking. It’s usually during this time that they start developing tremors. 

Those with severe cases of AUD may slip into a hallucinatory state, called delirium tremens, during withdrawal. In this case, medications and close medical supervision are required. Likewise, a person battling an acute case of alcohol dependency may start having seizures along with delirium tremens.

Managing Tremors During Alcohol Withdrawal

Some people can experience minor alcohol withdrawal symptoms, including tremors, without the need for medication. For more intense withdrawal cases, doctors may prescribe benzodiazepines, gradually tapering the doses as the symptoms subside. 

The severity of the tremors and other withdrawal signs dictate the dosage levels. Extremely ill in-hospital patients may require treatments with intravenous diazepam.

Along with tremors, the potential for alcoholic seizures is high. Epileptic episodes in people struggling with AUD are fairly common and are up to three times more likely in heavy drinkers than in the general population. Abrupt cessation of alcohol after prolonged, excessive drinking can trigger both severe tremors and seizures. 

Clinicians attribute both alcoholic shakes and seizures to fluctuating levels of calcium and choride passing through the bloodstream to the brain. Drinkers can experience tremors and seizures that are not non-alcohol-related and are, in fact, more susceptible to these events than the general population.

Here are just a few proven approaches for successfully managing alcoholic tremors.

Increase Hydration

The best approach for stopping alcoholic tremors in the immediate term is to stay hydrated and avoid caffeinated beverages. Drinking more water lessens alcoholic shakes, flushes the system of toxins, and aids the overall detox process. 

Likewise, drinks that contain electrolytes can help restore balance to the system after binge drinking events and problematic alcohol use over an extended time. The additional hydration also helps improve kidney and bowel function alike. 

A Nutritious Dietary Plan

Doctors also recommend avoiding sugary foods and drinks during detox, which only makes alcoholic tremors worse. Instead, AUD patients suffering from withdrawal should focus on a protein-rich diet that includes lean meats, nuts, nut butter, and non-fat dairy products. Whole grain and fruit-based diets are generally too high in sugar and should be avoided during the early stages of recovery. 

Eating small meals throughout the day during treatment is similarly recommended. This habit will help stimulate a healthy metabolism while reducing alcohol cravings instigated by hunger. 

Health supplements like vitamin B-complex, vitamin C, potassium, and magnesium can account for specific nutrient deficiencies common to AUD. These supplements and minerals may be appropriate under certain circumstances. A qualified provider can make this determination after completing the appropriate assessments.

Reduce Stress

Lowering stress through meditation practices like yoga can improve general well-being and mindfulness while inviting a more positive outlook during the recovery process. The deep, slow, breathing exercises associated with medication assist with relaxation and enhance respiratory health. 

The recovery stages of addiction are stressful. Any activity, from meditation to additional exercise, that reduces anxiety will help manage both alcoholic tremors and cravings. Healthier behaviors like these can make the transition to sobriety easier as the body adjusts to the alcohol leaving the system. 

Establish a Support Personal Network 

Finding a healthy and reliable support system is one of the most effective ways to ensure a lasting recovery. A trusted personal network can be invaluable for those battling AUD because they are less likely to feel alone and relapse into old drinking behaviors. 

A substantial support system only increases the likelihood of a successful addiction recovery. Support that continues after the detox is just as crucial as in the early stages of treatment. Those who participate in family counseling sessions and other group meetings improve their chances of managing tremors in the early stages of withdrawal and ultimately defeating the addiction. 

Ensure Adequate Sleep

Developing healthy sleep habits plays a vital role in reducing the bodily stressors associated with alcohol withdrawal syndrome, including tremors. Insomnia is a frequent problem for people in recovery, and the lack of sleep only worsens the withdrawal symptoms. 

Establishing a regular sleep schedule is often easier said than done, however. Depending on usage levels, it can take weeks or even months to find a normal sleeping pattern after cutting alcohol out entirely. Healthier exercise habits, an improved diet, and the meditation practices discussed above are all effective ways to clear the mind and develop healthier sleeping habits.

Follow the Detox Plan

For people in medically assisted detox programs, overcoming alcoholic tremors and other withdrawal symptoms requires close adherence to the recommended treatment plan. Managing these symptoms can make all the difference between life and death. 

The time it takes to detoxify the body depends on a few factors, such as consumption levels, history with alcohol, and the patient’s physical and mental attributes. Those who have gone through detox programs before may be able to complete the process sooner. However, every recovery situation is unique. In general, the most intense withdrawal symptoms peak within 72 hours and subside after two weeks. 

Finding Help for Alcohol Use Disorder

If you or someone you care for needs support in overcoming alcohol use disorder, you’re hardly alone. AlcoholAwareness.org offers a beacon of hope along with countless invaluable resources to get you or your loved one back on the path to recovery. 

Our friendly, welcoming staff is just a phone call away at our free, 24/7 Alcoholism Hotline. We offer safe, judgment-free consultations to get you connected with the addiction recovery support you need. Our obligation-free, confidential services mark the first step in overcoming your problems with alcohol. 

We offer a Support Groups Locator that can put you in touch with a network of addiction specialists who understand your unique needs and can set you on the path to a successful recovery. Alcohol use disorder is not a battle you have to fight alone. Call our free, 24-hour hotline at (855) 955-0771 now to discover how to find the help you need today.

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