Alcohol Withdrawal Tremors “The Shakes”: What Are They?
Updated: January 6, 2021
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Most experts agree that alcohol consumption is safe in moderation. However, drinking large quantities of alcohol and drinking to the point of intoxication, especially if done repeatedly, can be dangerous.

Eventually, repeated heavy drinking can lead to a clinical condition called an alcohol use disorder, the medical term for alcoholism or an alcohol addiction. One of the signs of an alcohol addiction is withdrawal.

Alcohol withdrawal occurs because over time, the body can become dependent upon alcohol, meaning that it does not function properly without it. When a person who is dependent upon alcohol stops drinking or reduces the amount of alcohol that he or she consumes, it can result in uncomfortable withdrawal symptoms. Tremors are one such symptom.

What are alcohol withdrawal tremors?

Alcohol withdrawal tremors are also known as “the shakes.” As the National Institute of Neurological Disorders and Stroke has explained, a tremor typically involves shaky hands, arms, legs, and head. Those who are experiencing tremor or “the shakes” may have difficulty with tasks like writing or holding a spoon.

A study in the medical journal Electromyography and Clinical Neurophysiology found that patients experiencing alcohol withdrawal had postural tremors. This means that they experienced shakiness when their bodies were operating against gravity, such as when their arms were outstretched.

When do alcohol withdrawal tremors occur?

According to the World Health Organization, alcohol withdrawal symptoms can begin 6 to 24 hours after a person stops drinking. As the authors of a report in American Family Physician have explained, tremors, which typically occur in the hands, are among the more mild symptoms of alcohol withdrawal. Tremors tend to be one of the first alcohol withdrawal symptoms that appear within a day after the last drink.

Per experts from UC Davis Medical Center, mild symptoms like tremor typically go away on their own if they do not progress to more severe withdrawal symptoms within a day or two.

How long do tremors last during alcohol withdrawal?

As experts writing for the Industrial Psychiatry Journal have explained, minor withdrawal symptoms, including tremors, tend to last for about a day or two. On the other hand, in cases of more severe alcohol withdrawal, symptoms like tremor may persist for up to two weeks.

Can tremors be a sign of something more serious?

While tremors are usually considered a rather mild symptom of alcohol withdrawal, there are cases when they can be a sign of a serious complication called delirium tremens. Delirium tremens can be fatal, and symptoms of this condition usually appear two to three days after a person stops drinking, according to the Industrial Psychiatry Journal.

The condition may develop following alcohol withdrawal seizures, and it includes symptoms such as agitation, hallucinations, extreme confusion, sweating, elevated heartrate, and tremor. When tremor occurs two to three days after the last drink and is accompanied by other symptoms, especially disorientation, it could be a sign of delirium tremens, which indicates that a person is in need of emergency medical treatment to prevent severe complications.

How are alcohol withdrawal tremors treated?

As previously mentioned, tremors can be a sign of mild alcohol withdrawal, which typically resolves on its own so long as symptoms do not worsen and a person’s vital signs remain normal. If this is the case, people may be able to recover from alcohol withdrawal symptoms at home without medication. Even if mild withdrawal does not require medications or hospitalization, it is still important to rest and consume plenty of fluids and a healthy diet while detoxing from alcohol. It is also wise to reach out to a medical professional to ensure safety during detox.

While tremor is typically associated with mild alcohol withdrawal, there are cases where it can signify delirium tremens, which can be fatal. Unfortunately, if withdrawal complications are not treated appropriately, they can quickly progress to delirium tremens. This is why it is important to consult with a doctor before withdrawing from alcohol. A doctor or other medical professional can evaluate symptoms and risk factors for delirium tremens to ensure that a patient receives adequate treatment.

Per the Industrial Psychiatry Journal, benzodiazepine drugs like Valium and Librium are often the first choice for treating alcohol withdrawal symptoms. The research shows that benzodiazepines can reduce the risk of seizures or delirium tremens, so they can be a useful treatment for those who experience tremors alongside severe withdrawal symptoms.

In summary, tremor is a common symptom associated with minor alcohol withdrawal, and it may go away on its own within a few days. On the other hand, some people may progress to more severe alcohol withdrawal states, in which tremor occurs alongside a potentially fatal condition called delirium tremens. If tremor occurs with symptoms such as headache, upset stomach, and anxiety within a day after the last drink, it is probably a minor withdrawal symptom. When a person has tremor along with severe confusion, hallucinations, and fast heart rate, this is indicative of delirium tremens, which requires medical treatment, often with benzodiazepine drugs.

While tremor may go away on its own, it is also best to reach out to a doctor or addiction treatment professional when withdrawing from alcohol. Tremor may be nothing serious, but since withdrawal can quickly progress to a potentially fatal condition, it is important to be under the care of a professional when detoxing from alcohol.