Alcohol Withdrawals

Alcohol and the shakes: Defining tremors from withdrawals

It’s 6am on Monday morning. You wake up, headache throbbing, sweating profusely and you reach over for something liquid next to your bed. The lukewarm water in the glass splashes all over the place as you attempt to bring it to your mouth. You have an uncontrollable shake that you just cannot get rid of. It’s called the ‘alcohol shakes’ and is loosely defined as the tremors caused by Alcohol Withdrawal Syndrome, which occurs in some frequent alcohol users when they suddenly stop drinking. 

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It is part of a condition called alcohol withdrawal syndrome that occurs in approximately half of the population who are considered heavy alcohol users. In the mild form typical symptoms other than tremor include sweating, anxiety, restlessness, nausea, headaches and the craving for more alcohol. More severe forms of withdrawal can lead to seizures, delirium tremens and hallucinations and shockingly, in some cases without treatment can lead to death.

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So why the Shakes?

The shakes are not actually caused by alcohol in your body, but rather as a result of the absence of it.  Your body is in shock at the lack of alcohol within your system and the shakes are one of the resulting effects of the physiological imbalances which happen after a prolonged period of heavy drinking.

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The science behind the shakes

As you are aware, alcohol as a depressant effect on the human body and of course, the heavier the consumption, the more the human brain becomes used to the lowered levels of stimulation. Scientifically speaking alcohol lowers the activity of the central nervous system by increasing activity of the main inhibitory (depressant) neurotransmitter gamma-amino butyric acid (GABA). In response to the chronic increase in GABA activity, the brain reduces the number of GABA receptors in parts of the brain, in order to compensate. That’s a lot to take in but essentially what it means is that there is an imbalance that is worsened when alcohol suddenly leaves your body. When this happens, the brain has less of the depressant effect of alcohol but also fewer of the depressant GABA receptors because of the now reduced number. This leaves the brain in an overall excited state and this is what causes those infamous shakes.

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How serious are the shakes?

Having the shakes can be irritating and embarrassing, but that’s about it. What is serious is that is a sign of alcohol withdrawal which, in some people can lead to far more serious consequences. The shakes are also a strong indication that the person has a severe alcohol use disorder.

More complicated withdrawal can lead to hallucinations, seizures or a condition known as “delirium tremens” – a medical emergency which requires specialist inpatient care.

Alcohol shakes, seizures and related actions are not limited to a certain time frame. While the shakes begin a few hours after drinking, seizures typically occur between 6 and 48 hours after stopping or reducing drinking. After 48-72 hours they may get delirium, which in severe cases, can lead to death.

What is the definition of “delirium tremens?”

Broadly defined delirium tremens is a neurologic syndrome resulting from and marked by changes in mental status and autonomic nervous system excitation. Symptoms include:

• Confusion
• Anxiety
• Fever
• Body tremors
• Rapid heartbeat
• Sweating,
• Severe confusion
• Agitation
• Hallucinations
• High blood pressure.

Regrettably, delirium tremens has a high mortality rate, just under 10% and it is therefore extremely important that people are treated in a safe and secure environment such as Houghton House Addiction & Mental Health Treatment Centres.

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How can a person combat the shakes?

When alcohol shakes and tremors become more than just a bad hangover and are signs of alcohol withdrawal, clinical interventions are needed.

In a residential detox and rehab centre the withdrawal process is carefully monitored by medical staff, to minimise potential risks. The process of detoxification involves weaning a person from a substance in a safe and effective manner, by gradually tapering out its use. This minimises the withdrawal symptoms and helps prevent complications.

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How long do the shakes last?

The duration of the shakes is heavily dependent on a number of factors including how much someone drinks, the duration of their drinking episodes and the regularity of said drinking episodes. Other factors include gender, age, weight and family history of addiction. It is important to note that if you get the shakes when you cease to drink suddenly, then it is a sign that your body has built up a dependency on alcohol and that it is time to get professional help.

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What’s the safest way to treat alcohol shakes?

Because of the risk of delirium tremens – and the fact it can cause death – if someone suffers from severe alcohol shakes it’s important to seek a safe, medically-led detoxification programme, where your symptoms can be managed carefully. We advise anyone with even the slightest doubt or concerns to give us a call immediately. We are here to help you and your loved ones.

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