The experience of uncontrollable tremors or shakiness of the hands or other body parts is not uncommon among those who are alcohol-dependent. Most of the time, a person with a drinking problem who has tremors is exhibiting indications of acute alcohol withdrawal. Still, there are also other reasons why an alcoholic might be displaying this symptom.
Alcohol is classified as a central nervous system (CNS) depressant, and as such, inhibits brain activity and reduces energy levels. When a person consumes an excessive amount of alcohol routinely, his or her body grows accustomed and adapts to the substance’s continued presence.
In an attempt to offset the sedating effects of alcohol, the brain releases more excitatory neurochemicals than usual, increasing nerve activity and keeping the brain and body in a heightened state of alert. These alterations in brain chemistry are part of why long-term, heavy alcoholics sometimes don’t appear to be as intoxicated as a non-dependent person would be when consuming the same amount of alcohol.
However, when a chronic alcohol abuser suddenly stops drinking, the brain continues to function as if it were still being exposed to alcohol. In this accelerated state, an individual will begin to feel withdrawal symptoms, including tremors, anxiety, sweating, accelerated heart rate, and nausea and vomiting.
Tremors and other unpleasant effects of alcohol withdrawal can manifest as soon as 6 hours after a person has taken their last drink. This symptom is why many people who are dependent on alcohol wake up shaky in the morning and feel like they need a drink—also known as a “hair of the dog”—to steady themselves.
Some individuals can experience a severe form of alcohol withdrawal known as delirium tremens (DTs) that is hallmarked by severe shakiness or tremors. Other symptoms of DTs include extreme agitation, irritability, terrifying hallucinations, delusions, hypertension, fever, and seizures.
Because DTs symptoms can be life-threatening, individuals attempting to stop using alcohol are advised to undergo medically assisted alcohol detox. Alcohol withdrawal symptoms are typically at their worst between 1-3 days and subside within five days. However, some people develop protracted emotional alcohol withdrawal symptoms that can persist up to a year.
Alcohol-Related Brain Damage Can Result in Tremors
Regular and excessive alcohol use can also cause damage to the cerebellum, a region located near the top of the brain stem responsible for controlling balance, physical coordination, and fine motor movements.
Alcohol-related damage to the cerebellum can result in what is referred to as an intention tremor or a specific type of trembling that is most apparent when a person makes a deliberate or goal-oriented movement toward an object.
Other symptoms of alcohol-related cerebellar dysfunction include the following:
- Impaired coordination and balance
- An unsteady gait
- Involuntary back-and-forth eye movements (nystagmus)
Some individuals also incur damage to the peripheral nervous system, resulting in muscle weakness, numbness, and tingling or burning pain in the extremities, referred to as peripheral neuropathy.
Damage to the cerebellum from consuming excess alcohol usually takes around a decade to occur and can be identified on an MRI scan as shrinkage in the cerebellum. It is thought to be the result of the toxic effects alcohol has on the brain and nutritional deficiencies such as the B vitamin thiamine, which is common among those who have developed a chemical dependence on alcohol.
Once signs of brain damage related to alcoholism manifest, they will likely continue to worsen if drinking continues. The only way to prevent the worsening of symptoms is to quit consuming alcohol, although this should not be attempted without professional detox and medical invention.
Tremors Related to Liver Disease
Alcoholism can also cause liver disease, which, in extreme cases, can cause a characteristic flapping or trembling of the hands, also referred to as asterixis.
While there may be few apparent symptoms in the early stages of liver disease, extended liver dysfunction can result in many complications, including a potentially lethal brain condition known as hepatic encephalopathy (HE).
HE develops when the liver becomes unable to adequately filter toxins from the blood, which can induce brain cell damage. As these toxins, including manganese, ammonia, and other substances, accumulate in the brain, the individual starts to experience sleep disturbances, mood changes, and impairments in motor control, possibly including a flapping tremor.
Also referred to as “liver flap,” this tremor can often be witnessed when the person’s wrists and hands are extended outward as another individual pushes on the back on their hands. This phenomenon, which is typically present in the early stages of HE, is often compared to a bird flapping its wings.
Although HE can occasionally lead to coma and death, fortunately, the condition is usually resolved with appropriate treatment.
Regardless, the onset of HE is an ominous symptom. Around half of all patients suffering from liver cirrhosis die within one year of their first occurrence of the disorder, and 80 percent fatally succumb to liver failure within five years.
In conclusion, shakiness or tremors that occur when someone goes without a drink for several hours can indicate a physical dependence on alcohol and withdrawal syndrome. Uncommonly, it can be a symptom of brain damage or liver disease. Whatever the cause, tremors should not be dismissed and taken very seriously.
Treatment for Alcohol Addiction
Alcohol dependence can lead to many devastating health and social issues. Persons who suffer from this condition are urged to undergo detox and professional treatment and seek help from Just Believe Detox and Just Believe Recovery as soon as possible before the situation gets even worse.
We offer comprehensive, evidence-based services facilitated by caring health professionals who specialize in addiction. We provide those we treat with the resources and support they need to sustain long-lasting sobriety and wellness and reclaim their lives.
Our programs, which include both partial hospitalization and residential formats, feature a wide variety of curative therapies and activities, including the following:
- Behavioral therapy
- Individual counseling
- Family counseling
- Relapse prevention
- Group support
- Substance abuse education
- Health and wellness education
- Art and music therapy
- Aftercare planning
- Alumni events and activities