How long do the shakes from alcohol withdrawal last?

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How long do the shakes from alcohol withdrawal last?

Shakes from alcohol can last for a few hours, several days and even for more than a week. Shakes can start about 5 to 10 hours after your last drink and can peak at 24 to 48 hours.

The duration is different depending on the individual. Factors that influence how long the shakes last include the severity of alcohol dependence.  

Alcohol abuse affects the nerve activity in the brain. When a person chooses to stop drinking, the brain and the body re-adjust to the absence of alcohol in the system. This readjustment is what leads to alcohol shakes or tremors.  

The shakes can appear on the hands or can happen to the body. The alcohol detoxification treatment will trigger of a variety of symptoms. These symptoms range from mild to severe depending on the duration of alcohol use. 

If the person engages in excessive alcohol use and suddenly stops, they are at risk of severe withdrawal symptoms. Some symptoms can be severe and life threatening.  

Typical withdrawal symptoms include:  

Nausea and vomiting, excessive sweating, anxiety, insomnia, headache and shakes or tremors.  

Delirium tremens (DTs) is the severe form of alcohol withdrawal symptoms. Only 5% of patients with withdrawal symptoms develop delirium tremens [1]. The symptoms for DTs are severe and potentially fatal.

They include: 

  • Hallucinations and delusions 
  • Impaired consciousness 
  • Confusion 
  • agitation, aggressiveness, or irritability  
  • Racing heartbeat  
  • Tremors or shakes  
  • Seizures  

People at risk of developing severe withdrawal symptoms have a history of chronic alcohol use.

People who have previously experienced severe alcohol withdrawal symptoms and a person who suddenly stops after a period of heavy drinking is likely to have severe alcohol withdrawal symptoms.  

Still, it is important to note that people respond to alcohol detox differently. Some people may take a few weeks before the symptoms show.

Since it is difficult to predict the intensity and duration of alcohol withdrawal symptoms, it is advisable to go for detox in a medical treatment facility or a rehab centre.  

What are alcohol shakes or tremors?

Alcohol shakes or tremors signify that the body is going through the detoxification process.

The shakes are involuntary or uncontrollable shaking in one or multiple areas of the body. These shakes can either occur constantly or at irregular intervals.  

The shakes are as a result of the effect of alcohol in the brain. Alcohol is a depressant and what it does is that it alters the chemistry of the brain.

Alcohol's effects on the areas of the brain that control the muscles is what leads to the shakes.  

The tremors or shakes on their own are not life threatening but can be embarrassing. Also, they can make it difficult for a person to carry out everyday tasks.

The tremors begin about 5 to 10 hours after one stop drinking alcohol and can peak at 24 to 48 hours.  

The shakes or tremors are diagnosed depending on: 

a). The severity of the withdrawal symptom. Most patients experience withdrawal symptoms about 6 hours after their last drink.

In some, the withdrawal symptoms may begin sooner. The symptoms peak by 24 to 72 hours and can persist for several weeks.  

b). Addiction experts also classify the types of tremors by their source and appearance. So far there are 20 types and include: cerebellar tremor, vibratile tremors, enhanced physiologic tremor etc.  

c). The tremors manifest as a rhythmic shaking in the body, typically the hands. The person as trouble writing, drawing, or driving.

They may struggle to hold or control objects such as utensils. Also, the patient may experience a shaky voice.  

d). The tremors can signal the onset if delirium tremens, although this severe form of alcohol withdrawal occurs in 5% of patients.  

e). Tremors are diagnosed based on a person's medical history and after a physical and neurological examination.  

It is possible to predict whether you or a loved one are likely to experience symptoms of alcohol withdrawal. It all depends on the level of physical dependence.

If you or your loved one drink heavily, and stop abruptly, you are at risk of experiencing tremors and other symptoms.  

What causes alcohol shakes or tremors?  

The alcohol shakes or tremors are as a result of the effects of alcohol on the brain. It is well known that alcohol affects motor control, that's why it is a public hazard to drink and drive.

There are studies that show acute alcohol delays reaction time and adversely affects cognitive and motor processing [2].  

Since alcohol is a depressant, it affects the nervous system by depressing the central nervous system by mimicking the neurotransmitter the neurotransmitter gamma-aminobutyric acid (GABA).  

This tilts the brain chemistry as it disrupts the equilibrium between the inhibitory and excitatory neurotransmitters such as glutamate resulting in reduced excitability of the brain and central nervous system(CNS) [2].  

When one suddenly stop drinking alcohol, the CNS experiences glutamate excitation due to the absence of alcohol. The body tries to regain the equilibrium that was there before the alcohol use.  

This is responsible for the appearance of symptoms identified with alcohol withdrawal such as alcohol tremors, tachycardia (heart rate of 100 beats per minute), seizures, and even delirium tremens.  

Most patients experience tremors in their hands. But some may experience them in other parts of the body. Even if you do not consider yourself an alcoholic, there are ways that you may be misusing alcohol.

Binge drinking, for instance, can lead to hangover shakes. You may feel your hands, or your entire body is shaking depending on the amounts you've consumed.  

Alcohol shakes are a sign of alcohol dependence or alcoholism. When your body builds up a tolerance to alcohol, reducing it will lead to alcohol shakes.  

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How much alcohol do you have to drink to experience tremors? 

Alcohol tremors are one of the symptoms of withdrawal that's likely to affect heavy drinkers.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), heavy drinking occurs when you take more than 2 drinks in a day for men and more than 1 drink in a day for women [3]. 

NIAAA defines binge drinking as a pattern of alcohol intake that brings blood alcohol concentration to 0.08% or at least or 0.08 grams of alcohol per decilitre. 

For an adult, this means taking 5 or more drinks (male) and 4 or more drinks (female) in about 2 hours [3]. People who binge drink are also at risk of experiencing alcohol tremors. 

The NHS defines binge drinking as drinking more than 8 units in a single session (men) and 6 units of alcohol in a single session for women.  

For example, 6 units is about 2 pints of beer containing 5% alcohol or two large 250ml glasses of 12% wine [4].  

8 units are about 5 bottles (330ml) of beer that contains 5% alcohol content or 5 small glasses of 13% wine. 

Alcohol misuse can also lead to tremors upon withdrawal. The National Institute of Health defines alcohol misuse as drinking in a harmful way or when you become alcohol dependent.

This can happen when you take more than 14 units per week (whether man or woman) [5].  

A unit of alcohol contains 8 to 10ml of pure alcohol. That's about half a pint of lower to normal strength beer/cider/lager or a single shot of spirits measuring 25ml. A small glass of wine has about 1.5 units of alcohol. 

People at risk of developing delirium tremens are people who have a history of alcohol. It is common among people who take 4 to 5 pints of wine, 7 to 8 pints of beer, or 1 pint of "hard" alcohol daily.  

This severe withdrawal symptom is also likely to affect people who have taken alcohol for more than 10 years. 

Most people are not aware if they have become alcohol dependent or not. The symptoms to look out for are: 

  • You have a strong compulsion to drink. 
  • You struggle to control the amount you take. 
  • You experience withdrawal symptoms. 
  • There's evidence of tolerance, which means that you have to take more than you used to achieve the same effect of high. 
  • Neglecting other responsibilities, interests, or hobbies to spend time drinking or recovering from the effects of drinking. 
  • Persisting with drinking alcohol despite physical and mental harm, e.g., memory problems, hangover shakes, mood swings. 

It's important to seek addiction treatment if you realize that you struggle with alcohol addiction. If you tried to stop before and relapsed, it would be best to go for detox under medical supervision. 

What are the treatment options for shakes or tremors? 

The best treatment option for shakes or tremors is to medically detox. The addiction specialist will come up with a treatment plan that will help you better manage withdrawal symptoms.  

Treatment at a rehab centre or medical care facility will provide you with the support you need to go through recovery. Furthermore, you'll get support for your physical and psychological needs. 

Since withdrawal symptoms vary depending on the individual, the ideal treatment for the tremors also differs depending on the withdrawal severity.

Some people may experience mild withdrawal symptoms, whereas, in others, the tremors may stop without treatment. 

Those who seek treatment may have to take drugs such as benzodiazepines. This class of drugs treats withdrawal symptoms such as anxiety, seizures, and sleep disorders.

Sometimes doctors will use a sedative such as a barbiturate to treat the shakes or tremors. 

If you have been using alcohol for a long time, it is best to seek addiction treatment. You can go for addiction treatment in an inpatient or outpatient setting.

A medical professional will monitor your symptoms to ensure that they don't become dangerous.  

Read the Abbeycare alcohol detox programme here.

If you go for outpatient, the medical practitioner will give you a benzodiazepine prescription to relieve symptoms.

You might also have to report to the clinic daily to ensure that your body responds well to the medication. 

The inpatient treatment option is a better option, especially for patients who are chronically dependent on alcohol. Inpatient provides you with medical attention so that other withdrawal symptoms can be managed.  

These symptoms include high blood pressure, vivid hallucinations, severe confusion, and other co-occurring disorders. The prescribed medications will help relieve the symptoms and cause the tremors to subside. 

Once detox is complete, the patient can progress to other forms of treatment. This typically includes individual and group therapy, family counselling, alcohol education, and support groups such as 12-steps. 

Aside from seeking professional help, other ways can help you reduce tremors. They include: 

a).  Take lots of fluids: Staying hydrated during the alcohol detox process helps flush the toxins out of your body. This, in turn, lessens the shakes and helps relieve other withdrawal symptoms. 

b).  Adopt a nutritious diet: A poor diet, including sugary foods, worsens the shakes. Instead, you should opt for fruits and a diet full of lean proteins.

You should also consult with your doctor for recommendations regarding vitamin and mineral supplements. 

c).  Practice stress management techniques: Most people experiencing withdrawal symptoms struggle with feelings of anxiety, fear, and stress.

These negative feelings can intensify symptoms of withdrawal, such as tremors. Practices such as meditation, yoga, mindfulness, acupuncture, and visualizations can help manage the negative feelings. 

d).  Get enough sleep: Insomnia is a common withdrawal symptom. This symptom can make alcohol shakes or tremors worse.

However, practicing stress management techniques can help you sleep better. Also, going to bed with a calmer, clearer mind will improve sleep. 

e).  Work on your relationship with your peer support network: Your family and close friends can provide you with valuable support during the recovery process.

You can work with your loved ones to help you maintain an alcohol-free environment.

You can also encourage them to participate in family counselling or attend support group meetings with you. Such involvement improves your chances for success in recovery. 

f).  Persist on your road to recovery by following your treatment programme: After detox, you should continue working on other treatment options such as counselling, 12-steps, and other after-care services. 

Conclusion 

Excessive alcohol consumption puts you at risk of developing shakes, or as they are called tremors.

The onset of these withdrawal symptoms varies from one person to another. The tremors tend to show up hours after the last drink. 

The shakes are a sign that the brain is trying to break free from the effects of the alcohol toxins. The symptoms can become extremely dangerous depending on your duration and intensity of alcohol use.  

The withdrawal symptoms may vary from mild to severe, for instance, delirium tremens is a severe manifestation of the withdrawal symptoms.  

It's important to seek professional to treat withdrawal symptoms and manage the shakes. Remember that alcohol affects your physical and mental health.  

By reaching out to a medical provider, you increase your chances of helping your body detox and developing coping mechanisms that will prevent you from relapse. 

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About the author

Laura Morris

Laura Morris is an experienced clinical practitioner and CQC Registered Manager with over twenty years experience, over ten of which have been as an Independent Nurse Prescriber.

She has held a number of senior leadership roles in the substance use and mental health sector in the NHS, the prison service and in leading social enterprises in the field.

Last Updated: January 5, 2024