Why Do Alcoholics Shake?

A tremor is when, in one or multiple areas of the body, involuntarily contracting muscles cause shaking.Experiencing body tremors is one possible symptom of withdrawal that may arise when you stop suddenly drinking or significantly decrease your drinking after a long period of too much alcohol use.Repeated alcohol use can cause the brain to acclimate, and this is thought to be responsible for dependence on alcohol.1

Additionally, alcoholism can damage a part of the brain called the cerebellum, causing a cerebellar tremor. There are also several other things that can cause a tremor which are unrelated to alcohol.

In general, tremor can happen in areas such as the vocal cards, legs, head, and more, but it most frequently occurs in the hands.

Alcohol Withdrawal

Withdrawal can follow a sudden stoppage of drinking or a sudden significant decrease in drinking by a person who is dependent on alcohol.Typically, acute alcohol withdrawal symptoms begin from 6 hours after a person’s most recent alcoholic beverage to 24 hours after.4

Marijuana overdose may lead to anxiety and mental confusion.

Some alcohol withdrawal symptoms may include:2,4,5

  • Anxiety.
  • Irritability.
  • Tremor.
  • Nightmares.
  • Headache.
  • Sweating excessively.
  • Quick heartbeat.
  • Trouble sleeping.
  • Seizures.
  • Hallucinations.
  • Delusions.
  • Delirium.

Alcohol withdrawal can be deadly. A person who could possibly be experiencing withdrawal from alcohol should immediately contact a healthcare provider or go to an emergency department. If a person hallucinates, has a high temperature, has heartbeats that are not regular, has seizures, or has confusion that is significant or serious, immediately call 911 or get to an emergency department.6

Delirium Tremens

In some cases, a serious kind of alcohol withdrawal called delirium tremens (also known as alcohol withdrawal delirium) can occur.5,7 As soon as 48 hours after suddenly stopping alcohol intake, delirium tremens can occur in someone who abused alcohol long-term, but delirium tremens symptoms might occur even 10 days post a person’s most recent drink.7,8

Signs of Delirium Tremens

alcoholic shakes tremors delirium tremens

Some symptoms of delirium tremens may include:7,8

  • Tremors.
  • Significant confusion.
  • Disorientation.
  • Hallucinations.
  • Agitation.
  • Heavy, prolonged sleep.
  • Elevated temperature.
  • High blood pressure.
  • Quick heartbeat.

Delirium tremens may be deadly.A person with delirium tremens symptoms should immediately call 911 or get to an emergency department.8

Treatment for Withdrawal & Addiction

Alcohol withdrawal can be deadly.6 A person who could possibly be experiencing withdrawal from alcohol should read what to do in the “Alcohol Withdrawal” and “Signs of Delirium Tremens” sections above.

If an individual experiencing alcohol withdrawal symptoms quickly obtains medical care, this may prevent delirium tremens, and averting delirium tremens is highly important.4,8 Typically, admission to a hospital or another setting that provides round-the-clock medical care may be preferable for detox for sedative-hypnotic withdrawal, alcohol withdrawal, and opioid withdrawal.4

Medications can be used to manage alcohol withdrawal, such as benzodiazepines. Medication may avert significant withdrawal ramifications. There should be provision of other care, including giving sufficient nutrition, screening for injuries, and more.4

However, for those with addiction, detox generally is not enough on its own to help them to stay abstinent long term. Treatment, such as cognitive-behavioral therapy, contingency management, and/or medication such as naltrexone, may help avert relapse. Treatment may be inpatient, residential, or outpatient. Self-help groups like Alcoholics Anonymous can offer support and assist individuals in becoming and staying abstinent.9

Recommended Treatment Considerations

Treatment-ChangesData were collected in 2016 by Recovery Brands asking patients leaving an addiction recovery center what facility features they saw as high-priority aspects to look at when deciding on treatment. The most important priority was the center’s financial options, such as financial support, insurance accepted, and payment options. They also prioritized the facility’s offerings (quality of housing, recreational activities, quality of food) significantly more after completing treatment. As you enter treatment, you may want to look at a center’s payment policies as well as its offerings to help you make your final program decision.


Ongoing care following the completion of formal treatment is another very important aspect of recovery. Aftercare in the form of continued counseling can help people stay focused on sobriety and continue to practice relapse prevention skills. Free self-help programs like Alcoholics Anonymous and SMART can also provide support and connection for recovering drinkers.


    1. S. Department of Health & Human Services. (2009). Alcohol Alert: Neuroscience: Pathways to Alcohol Dependence.
    2. Becker, H.C. (2008). Alcohol Dependence, Withdrawal, and Relapse. Alcohol Res Health, 31(4), 348-361.
    1. National Institute of Neurological Disorders. (2019). Tremor Fact Sheet.
    2. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and Substance Abuse Treatment.
    3. Newman, R.K., Stobart, M.A., Gomez, A.E. (2019). Alcohol Withdrawal.
    4. A.D.A.M., Inc. (2019). Alcohol withdrawal. In A.D.A.M. Medical Encyclopedia.
    1. Rahman A, Paul M. (2018). Delirium Tremens (DT)S. National Library of Medicine.
    2. A.D.A.M., Inc. (2019). Delirium tremens. In A.D.A.M. Medical Encyclopedia.
    1. National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).

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