After a night of indulging in alcoholic beverages, many individuals may experience a phenomenon known as alcohol shakes or tremors. These involuntary muscle movements can be unsettling and sometimes even alarming.

If you find that you shake the day after drinking, you’re not alone. Alcohol shakes, also known as alcohol tremors, are a sign of alcohol withdrawal and are very common among people who have a drinking problem.

Seeking early treatment for alcohol abuse and dependence is essential in preventing more severe, potentially life-threatening withdrawal symptoms. To learn about your alcohol detox and treatment options, please contact our team at ARISE Treatment Center today.

What are Alcohol Shakes?

Alcohol shakes or tremors are a tell-tale sign of alcohol withdrawal. These tremors are usually seen in the hands but can also occur in the arms or legs. Shakes usually occur 6-8 hours after the last drink and last more than two days.

Tremors themselves are a warning sign of alcoholism, but they aren’t inherently dangerous. However, if you keep drinking, your tremors may worsen, potentially indicating a severe alcohol withdrawal complication called delirium tremens (DTs). DTs are the most severe form of alcohol withdrawal which are characterized by seizures, hallucinations, delusions, high blood pressure, irregular heart rate, and high body temperature.

In addition to DTs, tremors can also be a sign of a more severe condition called Wernicke-Korsakoff’s Syndrome (also known as ‘wet brain’ or WKS). WKS develops after long-term heavy drinking as a result of thiamine (vitamin B1) deficiency. This condition affects your ability to think, recall memories, and move. While it can be reversed in its early stages, the late stages are not treatable.

Why Do I Get the Shakes After Drinking Alcohol?

Alcohol shakes and tremors are a symptom of alcohol withdrawal and they occur in people who have developed a physical dependence on alcohol. Physical dependence occurs after regular, long-term drinking. How quickly physical dependence develops varies depending on how much alcohol you drink, how long you’ve been drinking, your body chemistry, and your overall health.

Physical dependence develops because of the way alcohol changes your brain chemistry. Alcohol is a central nervous system (CNS) depressant, so it slows down certain bodily functions such as heart rate, breathing, and respiration. Alcohol enhances the effects of GABA, which is an inhibitory neurotransmitter, leading to a slowdown of brain activity. Simultaneously, alcohol suppresses glutamate, an excitatory neurotransmitter responsible for stimulating brain activity. To overcome these sedative-like effects, your body has to work harder in an over-excited state.

When you drink enough over a long period of time, your body gets used to having alcohol in the system. Then, when you suddenly stop drinking, neurotransmitters such as glutamate and gamma-aminobutyric acid (GABA) become imbalanced. Yet, your body continues acting in an over-excited state because it is expecting you to drink alcohol. This results in symptoms of withdrawal, such as tremors, anxiety, depression, restlessness, sweating, vomiting, seizures, and DTs.

More Reasons for Shaking After Drinking

In some cases, people may shake the day after drinking for reasons that are not related to alcohol dependence and withdrawal. These include:

1. Hypoglycemia – Alcohol can cause a sudden drop in blood glucose levels, potentially resulting in hypoglycemia (low blood sugar). Low blood sugar may trigger tremors.
2. Dehydration – Alcohol is a diuretic that increases urine production and dehydration. Dehydration can cause electrolyte imbalances which can result in muscle spasms or tremors.
3. Acetaldehyde buildup – The liver metabolizes alcohol into a toxic substance called acetaldehyde. Some people have a genetic predisposition that causes them to break down acetaldehyde at a slower rate, leading to its accumulation in the body. A build-up of acetaldehyde may result in shaking and physical discomfort after drinking.
4. Pre-existing medical conditions – People who suffer from pre-existing conditions such as essential tremors or Parkinson’s disease may notice their symptoms worsen after drinking because alcohol can exacerbate the tremors associated with these conditions.

How Are Alcohol Withdrawal Shakes Treated?

If you experience tremors or shaking after drinking, it’s important to seek professional help. The earlier you seek treatment, the better chances you have at avoiding serious health issues such as delirium tremens (DTs) and Wernicke-Korsakoff Syndrome (WKS).

There are a variety of treatment methods that can alleviate shakes and tremors. The exact treatment you receive will be tailored to your needs. Treatment options include:

• Benzodiazepine taper – Benzodiazepines target GABA in the same way alcohol does so that they can alleviate symptoms of alcohol withdrawal. They can also prevent tremors and seizures. During alcohol detox, doctors may prescribe a long-acting benzodiazepine like Librium or Valium. You may begin on a relatively high dose and your dose will gradually decrease over a period of days or weeks. Gradually reducing your dose, known as a taper, can prevent adverse side effects and ease your withdrawal symptoms.
• Thiamine supplements – If WKS is suspected, thiamine supplements may be provided to help increase thiamine levels and stop the progression of the disease.
• Propranolol – Propranolol is a beta blocker used to treat high blood pressure, irregular heartbeat, shaking/tremors, chest pain, and other conditions. During alcohol withdrawal, propranolol can help reduce tremors, anxiety, restlessness, and irregular heartbeat.

How to Get Rid of the Shakes After Drinking

If you experience tremors after drinking, you must talk to your doctor. But until you can be seen by a healthcare provider, there are steps you can take to alleviate your symptoms and protect yourself from further harm, such as:

• Stop drinking
• Rehydrate yourself
• Get plenty of rest
• Engage in relaxing activities like yoga or meditation
• Keep your body warm, yet comfortable
• Avoid driving

Get Help for Alcohol Abuse Today

Shakes or tremors after drinking are often a sign of a bigger problem. At ARISE Treatment Center, our medically-assisted alcohol detox and treatment programs can help you detox safely, keeping tremors at a minimum, and receive the comprehensive treatment you need to stay sober. To learn about our alcohol treatment programs or to get help for yourself or a loved one, please call us today. Our admissions counselors are available 24 hours a day to take your call and assess your needs.

References:

1. National Library of Medicine: Introduction to Alcohol Withdrawal, Retrieved July 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/
2. National Library of Medicine: When Drinking Makes the Tremor Worse, Retrieved July 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6183252/
3. National Library of Medicine: Delirium Tremens, Retrieved July 2023 from https://www.ncbi.nlm.nih.gov/books/NBK482134/
4. National Library of Medicine: Wernicke-Korsakoff Syndrome, Retrieved July 2023 from https://www.ncbi.nlm.nih.gov/books/NBK430729/
5. National Library of Medicine: Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond, Retrieved July 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606320/