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Alcohol Shakes & Tremors: Causes, Treatment, & Prevention

  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Modified:
  • Reading Time: 16 minutes
  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Last Update:
  • Reading Time: 16 minutes

Having alcohol shakes and tremors can be scary. However, knowing their causes, treatments, and prevention methods is important for anyone recovering from alcohol dependence.

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Alcohol is classified as a depressant substance. Its effects include slowing down parts of the central nervous system. It also interferes with chemicals that control emotions in the brain.

If you drink regularly and suddenly stop, your body may react quickly. Within just six hours, you could experience shaking and tremors as your system adjusts to the absence of alcohol.

Even if you don’t think of yourself as an alcoholic, you can still have tremors and shakes. This can happen, especially if you drink for fun. For instance, if you go to a party and binge drink—consuming a lot in a short time—you might end up with what’s known as “hangover shakes,” a common hangover symptom.

When these symptoms show up, they can sometimes be a sign of a deeper issue, like alcohol dependence. That’s why it’s so important to reach out for medical advice as soon as possible. Taking these signs seriously and getting the right help can greatly improve how you handle the situation. It can also help you start your recovery journey.

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Impact on Daily Life

What Are Alcohol Shakes?

Alcohol shakes are the uncontrollable tremors you might feel in your hands, fingers, arms, or legs. They usually occur when your body is adjusting after a long period of heavy drinking. The symptoms can change from person to person—you could feel slightly jittery or have intense shaking that makes simple tasks difficult.

This is how your body reacts when it doesn’t have alcohol. It can be a tough experience to deal with. They can disrupt everyday activities like writing, eating, or even holding a cup, making everyday life challenging.

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Withdrawal, Intoxication, & Medications

What Causes Alcohol Shakes?

Alcohol tremors and shakes are linked to how alcohol affects the body, especially the central nervous system. They usually fit into one of four groups: alcohol withdrawal, alcohol dependence, intoxication, or side effects from other drugs. Each of these situations can trigger tremors, and understanding which one is at play can help guide the right approach to treatment or care.

1. Alcohol Withdrawal

Alcohol is a substance that slows down the central nervous system. For those who drink in moderation, it can make you feel less energetic and slow down your Central Nervous System (CNS). However, if someone drinks a lot and often, their body starts to get used to the alcohol.

This means that heavy drinkers’ brains make more chemicals. These chemicals help you feel more awake. They balance the calming effects of alcohol. That’s why people who drink a lot might not seem drunk at all.

When your body gets used to high amounts of alcohol, it starts to adapt. It becomes dependent on alcohol to feel normal.

When you suddenly stop drinking, your central nervous system can go into overdrive. This can lead to hyperactivity. This shift can lead to various symptoms, one of which is shaking after drinking.

Symptoms of alcohol shakes can vary from person to person. They may start as soon as 6 to 8 hours after your last drink. This shaking is closely tied to alcohol withdrawal and serves as your body’s way of signaling that something is off balance. Other signs of alcohol withdrawal symptoms include:

  • Feeling anxious or depressed.
  • Sweating.
  • Being overly energetic.
  • A fast heartbeat.
  • Nausea and vomiting.

2. Alcohol Intoxication

When you consume alcohol, it enhances the effects of a neurotransmitter called GABA in your brain. GABA is a brain chemical that helps slow things down. This creates a sedative effect as it blocks certain signals in your central nervous system. This action calms your brain and reduces activity.

It also reduces the impact of another chemical known as glutamate, which usually keeps things firing. This mix can make you feel relaxed and sleepy. It can also cause signs of being drunk, like clumsiness, slurred speech, and tiredness.

However, excessive alcohol consumption or binge drinking can disrupt this delicate balance. When you consume a lot of alcohol quickly, it can cause your nervous system to become overly active. As a result, you might notice tremors or shaking in your hands because your brain is working hard to get back on track. These tremors indicate that your body is having a hard time coping with the quick changes caused by alcohol.

If you are a heavy drinker who has been at it for a long time can get the shakes, even while you are still drunk. It is because their brains have become used to alcohol, which messes with the chemicals that help with movement. When the body starts to get rid of the alcohol, this can lead to tremors and trouble with coordination. Strangely, the same chemicals that help you chill out can later make it tough to control your movements and keep your balance.

2. Medications

Medicines are important for treating alcohol shakes. They help make withdrawal symptoms easier to manage.

For example, doctors often give out benzodiazepines like diazepam to help calm anxiety and stop seizures during withdrawal. Beta-blockers can help with problems like a fast heartbeat and shaking. Anticonvulsants may be used to prevent seizures.

Your specific meds will be prescribed based on the severity of your symptoms and your general health. It’s very important to take them exactly as your doctor says. This helps avoid problems and ensures they work well. Having a doctor guide you through this process helps keep things on track and safe.

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Common Physical & Emotional Symptoms

What Are the Symptoms of Alcohol Shakes?

Alcohol shakes aren’t only about the trembling; they often come with various other physical and emotional signs. The strength and combination of these symptoms can vary. This depends on whether the shakes come from drinking too much, using calming substances, or withdrawing from alcohol.

1. Tremors

The primary symptom of alcohol shakes is the tremor or shaking itself. Tremors usually affect the hands, but they can also affect other parts of the body, including the legs, head, and face.

Alcohol-related tremors can be really different from person to person. Some people can just have a tiny shake that you can hardly see. For some people, the shaking can be much worse. This makes it hard to do everyday tasks like writing, holding a cup, or using a fork and knife.

In withdrawal cases, tremors usually start 6 to 8 hours after the last drink. They can last for several days as the body tries to adjust. These symptoms can manifest in several ways:

  • Individuals may experience chills that come and go.
  • Shivering can occur, often linked to low dopamine levels in the body.
  • Many people feel a sense of disorientation or a sense of detachment from their surroundings.
  • There may be noticeable rhythmic jerking in the hands or arms.
  • Some individuals experience mild twitching of the tongue and head, particularly those with long-term chronic alcohol use.
  • Lastly, there can be impaired movement in both the upper and lower limbs.

2. Nausea

Many people who stop drinking alcohol often experience shakes. These shakes can come with nausea and stomach problems, like vomiting and irritation.

Some patients have severe nausea, making it difficult to eat or drink. Drinking enough water and taking anti-nausea medicine can help with this discomfort. However, staying hydrated is usually best to see a doctor, especially if the nausea is strong during withdrawal.

3. Sweating

When you quit drinking alcohol, you might find yourself sweating a lot, especially if you’re also feeling shaky. It is your body’s way of reacting to the stress from not having alcohol. You could notice sweat on your palms, face, or underarms.

Sweating cools your body, but it can also lead to dehydration. This can make withdrawal symptoms, like headaches and tiredness, feel worse. Also, sweating a lot can make you feel uncomfortable or anxious. This can make it harder to handle the withdrawal experience.

4. Anxiety

When anxiety is very high, especially with shaking from alcohol withdrawal, it can cause a panic attack. In a detox setting, doctors and support teams work together. They help reduce anxiety, panic attacks, and other withdrawal symptoms.

If you struggle with anxiety, you may feel shaky or jittery. You might also have other symptoms, such as:

  • Panic attacks.
  • Sweating.
  • Increased heart rate.
  • Difficulty concentrating.
  • Nervousness.
  • Tightness in chest.
  • Irritability.
  • Restlessness.
  • Dread.
  • Sensitivity to light and sound.
  • Racing thoughts.
  • Muscle tremors.
  • Confused, disorganized thinking.
  • Rapid breathing.

At some point, we’ve all probably felt anxious — whether it’s before a big presentation, a tough conversation, or just out of the blue. For some people, anxiety can become stronger and last longer. This makes it harder to manage daily life.

When anxiety starts to really get in the way, doctors might diagnose it as an anxiety disorder. The American Psychiatric Association recognizes several types of anxiety disorders, including: 

  • Agoraphobia.
  • Generalized anxiety disorder.
  • Social anxiety disorder.
  • Panic disorder.
  • Separation anxiety disorder.

Feeling anxious about various aspects of your life can worsen your anxiety and panic attacks. This is especially true during alcohol withdrawal.

It’s very important to tell the treatment team about any mental or physical health issues. This includes problems like anxiety or depression when you begin an alcohol detox program. It will help them provide you with the right support and care during the detox.

5. Headache

Many things can cause alcohol-related headaches. One common reason is that alcohol is a diuretic. It causes you to urinate more frequently. Excessive loss of body fluids can eventually result in dehydration if you do not drink enough water.

Dehydration is a common trigger for headaches in some people. Also, when people drink, they may not notice how much water they are having. They might drink too much alcohol, which can make headaches worse. People also have different levels of sensitivity to headaches caused by alcohol.

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Medical History, Physical Exams, & Testing

How Are Alcohol Shakes Diagnosed?

The diagnosis of alcohol shakes usually starts with a careful look at your medical history. This includes your drinking habits.

A healthcare provider will use their knowledge to look for signs of alcohol dependence. These signs include frequent or heavy drinking, a history of withdrawal symptoms, and failed attempts to cut down on drinking. Other signs may also be present.

Medical History & Physical Examination

When you visit the provider, they will ask you questions about your alcohol consumption, like how much you drink and how often. They will also want to know if you have any other symptoms, such as shaking or feeling nauseous. During the physical exam, they will check how bad your shaking is. They will also look for signs of dehydration or other health problems related to alcohol use.

Laboratory Tests

There are different ways to find out if alcohol is in your system, and each method has its time frame for detection. The Blood Alcohol Concentration (BAC) test is very accurate.

It measures the exact amount of alcohol in your blood. This test can show results for up to 12 hours after you have been drinking. It is really helpful if you need to take a test soon after consuming alcohol.

Another popular method is the breath alcohol test, which police officers often use. It checks the alcohol in your breath and gives you results right away.

There are both manual and electronic breathalyzers, with the electronic ones being faster and more accurate. Urine tests can find alcohol for about 12 hours. Some advanced tests can detect it for up to 24 hours.

If you need to check for alcohol over a longer time, a toenail test could be a good option. This is especially true if other tests cannot be done for medical reasons. This test can show alcohol use over several weeks or even months.

There are screening tests that do not measure alcohol directly. These tests help understand your drinking habits and how alcohol impacts your life. Tests like the AUDIT (Alcohol Use Disorders Identification Test) or the CAGE questionnaire are examples of this. 

Also, blood tests can look for changes in your blood over time. For instance, a Mean Corpuscular Volume (MCV) test can indicate long-term alcohol use by showing changes in red blood cells. These tests help doctors see your drinking habits. They are useful if you are recovering or have struggled with alcohol for some time.

Diagnostic Criteria for Withdrawal

When alcohol withdrawal is a concern, doctors check for specific signs and symptoms. They use formal criteria to assess how serious the situation is and what treatment is needed. A common tool is the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar). It helps measure the strength of withdrawal symptoms.

This assessment covers ten key signs of withdrawal, such as tremors, anxiety, and nausea. A CIWA-Ar score of 15 or higher shows a greater risk of severe alcohol withdrawal symptoms. These symptoms can include confusion or seizures, which may need immediate medical help.

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) also provides criteria to confirm a diagnosis of alcohol withdrawal. The DSM-5 states that alcohol withdrawal is diagnosed when specific criteria are met. This includes stopping or reducing long-term heavy alcohol use. It also requires the development of at least two symptoms within hours to a few days after stopping alcohol.

  1. Autonomic hyperactivity (e.g., sweating, elevated pulse rate above 100 bpm).
  2. Increased hand tremor.
  3. Insomnia.
  4. Nausea or vomiting.
  5. Hallucinations or illusions (visual, tactile, or auditory).
  6. Psychomotor agitation.
  7. Anxiety.
  8. Generalized tonic-clonic seizures.

Additionally, these symptoms must be serious enough to cause noticeable distress. They should disrupt important parts of life, like work, relationships, or daily activities. They should not be caused by another medical illness or a mental health problem, such as substance abuse or withdrawal.

In some cases, withdrawal can cause perceptual disturbances. This means the person may have hallucinations, often visual or tactile.

However, they still have a clear sense of reality. It is a rare occurrence, but when it does happen, it’s noted as part of the diagnostic criteria. Understanding these criteria helps doctors determine the severity of withdrawal and guide treatment decisions effectively.

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Treating Alcohol Tremors

What Are the Treatment Options for Alcohol Shakes?

Treating alcohol shakes really depends on how severe your symptoms are and what’s behind them. If you are going through alcohol withdrawal, it is important to stabilize your condition. You should also manage the symptoms to stop them from getting worse. This treatment can include detox, medication, and therapy to help you safely get through the process.

1. Detoxification

Detox is often the first step in dealing with alcohol shakes, especially when they happen because of withdrawal. The main goal during detox is to reduce alcohol slowly. It is important to do this with medical help. This support can lessen severe withdrawal symptoms.

This process may take a few days. You will need to be watched closely. This is important if you have been drinking heavily or have a serious history with alcohol.

Sometimes, you might have to go to the hospital or join an inpatient detox program to stay safe while going through withdrawal. This way, you’ll have support and someone keeping an eye on you as your body gets used to not having alcohol.

2. Medications

Medicines are important for treating alcohol shakes. They help make withdrawal symptoms easier to manage.

For example, doctors often give out benzodiazepines like diazepam to help calm anxiety and stop seizures during withdrawal. Beta-blockers can help with problems like a fast heartbeat and shaking. Anticonvulsants may be used to prevent seizures.

Your specific meds will be prescribed based on the severity of your symptoms and your general health. It’s very important to take them exactly as your doctor says. This helps avoid problems and ensures they work well. Having a doctor guide you through this process helps keep things on track and safe.

3. Therapy

If you have been having trouble with alcohol, treatment can help you stay sober and prevent future problems. It gives you the tools and support to find your triggers. You can also develop better behaviors and handle recovery challenges. It’s not always easy, but having that support helps in the long run.

One effective type of therapy is Cognitive Behavioral Therapy (CBT). It helps you identify and change negative thoughts that lead to drinking. You might find it helpful to join group therapy or support groups like Alcoholics Anonymous (AA). These groups provide support and help you stay accountable as you work on staying sober.

Therapy plays a big role in helping you understand the real reasons behind your drinking. It also teaches you how to manage stress and emotions that might lead you back to drinking. The goal is to find better ways to cope and to create a strong network of support to keep you focused on your goals.

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How Can Alcohol Shakes Be Prevented?

To avoid tremors and shakes from alcohol, first, watch how much you drink. Also, address any problems you may have. By being aware of your drinking and seeking the right help, you can really reduce your chances of having tremors and other bad effects.

Stay educated and make the changes you need for your health. And remember, if you’re struggling, asking for help is a sign of strength, not weakness. It’s completely okay to reach out for support whenever you need it.

1. Limiting Alcohol Intake

If you want to steer clear of alcohol shakes, the best option is to drink less or even stop drinking completely. According to the CDC, men should limit their intake to two drinks a day, and women should have only one.

Drinking in moderation helps you follow these guidelines. It also lowers the risk of becoming dependent on alcohol.

You can avoid withdrawal symptoms, like shakes, by drinking less. It’s really important to find a balance to keep your body feeling good.

2. Managing Stress and Anxiety

Find ways to handle stress and anxiety to prevent alcohol dependence and the withdrawal symptoms that can follow. When you feel anxious or stressed, try relaxation techniques.

Meditation, exercise, and deep breathing can help. These methods can keep you from wanting to self-medicate with alcohol. Therapy, particularly Cognitive Behavioral Therapy (CBT), can also teach you effective stress-management skills that do not include alcohol.

When you discover healthier ways to handle stress and anxiety, you will be better prepared for tough times. This will also make you less likely to drink too much. It helps you manage your feelings better. It also gives you the skills to stop using alcohol to cope.

3. Seeking Help for Alcohol Addiction

If you’re finding it tough to deal with alcohol addiction, getting help is really important. Detox programs, therapy, and support groups can provide you with the support and skills you need to remain sober.

Drug and alcohol addictions are just as much diseases as conditions like cancer or high blood pressure. In many cases, professional care is essential. Treatment addresses both the physical and mental sides of addiction. This approach is important for preventing tremors and other health problems related to alcohol.

Worried About Shakes from Alcohol? Rolling Hills Recovery Center (RHRC) Will Help.

At Rolling Hills Recovery Center, we understand that alcohol shakes are a severe sign of alcohol dependency. Our alcohol rehab program offers expert, proven treatment to help you beat alcoholism. We also support you in managing related mental health issues, like shaking and tremors.

RHRC provides science-based therapies in a safe and calm environment. We aim to treat alcohol addiction and explore its root causes. Our goal is to help you achieve long-term recovery. We’re here for you every step of the way.

If you’d like to learn more about our successful, proven alcohol addiction treatment program, contact RHRC today. can be a sign of a serious condition called delirium tremens (DTs). This usually happens 2 to 3 days after heavy drinking.

DTs can be very dangerous. They can even become life threatening. They can change your thinking a lot.

You might see things that aren’t there. You might also believe things that aren’t true.

You might also have trouble with essential body functions, such as your heart rate, blood pressure, and body temperature. If you’re feeling any of these symptoms, asking for help is vital.

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Written By:

Geoffrey Andaria

Geoffrey Andaria mental health writer at rolling hills recovery center
Rolling Hills Recovery Center

Mental Health Writer

About Author:

Geoffrey Andaria is an experienced mental health content writer and editor. With a B.A. in English and Journalism, Geoffrey is highly educated in freelance articles and research. Having taken courses on social work, Geoffrey is adamant about providing valuable and educational information to individuals affected by mental health and the disease of addiction.

Medically Reviewed By:

Dr. Carl Williams Ph.D., LCADC

Carl Williams, medical content reviewer at rolling hills recovery center
Rolling Hills Recovery Center

Expert Contributor

About Reviewer:

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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