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Tremors, or “the shakes,” are a common symptom of alcohol withdrawal. While these tremors usually occur in the hands, they can happen anywhere in the body. Alcohol withdrawal shakes can be uncomfortable and frightening, but fortunately, there are steps you can take to manage this symptom. In most cases, these tremors go away on their own once you have completely detoxed, although this detox period can last anywhere from a few days to months or longer, depending on the damage to your liver and level of your addiction. During this time, your doctor can help you reduce withdrawal tremors with medications. Anxiety and stress can make tremors worse, so managing your stress levels during withdrawal and recovery is also important.
Things You Should Know
- Your doctor can prescribe medications, like Baclofen, that help stop alcohol withdrawal shakes.
- Supplement medication with stress-reducing activities, like yoga, meditation, and light exercise. Reducing stress can help reduce the shakes.
- Anything that alleviates your anxiety can also help. Things like spending time with loved ones, doing arts and crafts, and journaling can actually make a difference.
Steps
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Talk to your doctor about the best way to manage your tremors. If you are experiencing withdrawal symptoms after quitting alcohol, or if you’re thinking about quitting and want to minimize withdrawal symptoms, it’s important to discuss treatment and recovery options with your doctor. They can help you come up with a plan to get through your withdrawal period as safely and comfortably as possible. Although this appointment is a good start, remember that you’ll likely need to head to an inpatient recovery center to make a full recovery. You may also need to go to Alcoholics Anonymous meetings while you continuing getting medical attention from your doctor. Your doctor will probably ask you about: [1] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source
- Your regular drinking habits (i.e., how much you drink, and how often).
- Any symptoms you have been experiencing, even if they are not obviously related to drinking.
- Any medications, supplements, or drugs you are using.
- Other health concerns you may have.
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Discuss using baclofen as an alternative to benzodiazepines. Baclofen (Lioresal) is a type of muscle relaxant that works by affecting your central nervous system. [2] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Baclofen may be effective at treating a variety of alcohol withdrawal symptoms, including tremors. [3] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source
- Never stop taking baclofen abruptly without consulting your doctor. Talk to your doctor about the safest way to stop taking baclofen. [4] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source
- Tell your doctor about any other medications you are taking before you start taking baclofen. Baclofen may increase the effects of other central nervous system depressants, such as antihistamines, sedatives, or prescription pain medications. [5] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source
- Mild side effects include drowsiness, dizziness, vision problems, or clumsiness.
- Talk to your doctor if you experience any serious side effects, such as dark or bloody urine, hallucinations, mood changes, chest pain, fainting, ringing in the ears, or skin rashes. These side effects are much less common, but should be addressed if you experience them. [6] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source
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Ask about treating the shakes with benzodiazepines. Benzodiazepines are a class of medications that are used to treat many of the symptoms of alcohol withdrawal, including tremors. These are serious medications, and your doctor likely won’t prescribe them to you in your initial stages, or if you’re taking them outside of an inpatient facility. Talk to your doctor about this possibility to see if benzodiazepines will be necessary for you.
- Benzodiazepines commonly used to treat alcohol withdrawal include diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan) and oxazepam (Serax). [7] X Trustworthy Source American Academy of Family Physicians Organization devoted to improving the health of patients, families, and communities Go to source
- If used incorrectly, benzodiazepines can be dangerous. Only use benzodiazepines under the close supervision of your doctor.
- Possible side effects of benzodiazepine include dizziness, drowsiness, trembling, poor coordination, confusion, depression, impaired vision, or headaches. Long-term use comes with a risk of dependence. [8] X Research source
- Benzodiazepines can interact dangerously with certain types of drugs and medications, such as opioids, barbiturates, alcohol, and tricyclic antidepressants. Tell your doctor about any other drugs or medications you are taking. [9] X Research source
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Be very cautious when starting new medications. When alcoholics stop drinking, they often transfer their addiction to another source. That source can often be a medication prescribed by doctors to treat alcoholism and related symptoms, such as withdrawal shakes. Discuss this possibility with your doctor and talk about what you can both do to prevent it.
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Recognize the limits of medication. Medications can help alleviate the suffering of withdrawal and its symptoms, such as withdrawal shakes. However, they can never completely remove all symptoms. You may always have some shaking, but with proper care and treatment, you can make it manageable.
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Supplement medical treatments with stress management techniques . Stress and anxiety can make alcohol withdrawal tremors worse. While you should work with your doctor to come up with a safe medical treatment plan for dealing with alcohol withdrawal, stress management techniques can be helpful in providing further relief from shaking and other withdrawal symptoms. [10] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Try a few simple stress relieving activities, such as:
- Light exercise, like going for walks or taking a bike ride.
- Doing arts and crafts. If you are not particularly artistic, you can get many of the same stress-busting benefits by doing simple activities like coloring. [11] X Research source
- Keeping a journal.
- Engaging in favorite hobbies, or picking up a fun new hobby.
- Spending time with supportive friends.
- Reading a book you love, or watching fun movies or TV shows.
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Practice yoga to help you relax. Studies show that yoga can have many benefits for people going through withdrawal or recovering from alcohol dependence. In addition to having antidepressant qualities, regular yoga practice can help reduce concentrations of stress hormones in the body during and after detox. [12] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source If you don’t have experience doing yoga, consider signing up for a beginner class at your local gym or community center.
- Some substance abuse specialists incorporate yoga into their practice. Ask your doctor to recommend a therapist who is also a certified yoga practitioner. [13] X Research source
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Do mindful meditation to reduce stress and anxiety. Meditation can reduce stress and anxiety in people recovering from alcohol dependence, and may also play a role in preventing cravings and future relapses. [14] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source Ask your doctor or substance abuse specialist about incorporating meditation into your withdrawal treatment routine.
- You can also try meditation on your own by finding guided meditation videos and apps online.
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Try acupuncture to manage anxiety and depression. The effectiveness of acupuncture for reducing alcohol withdrawal symptoms is unclear. [15] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source However, some people find it helpful for reducing anxiety, stress, and depression. [16] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Relieving these symptoms may indirectly reduce withdrawal shakes and other symptoms that are made worse by stress and anxiety. Consider supplementing medical treatments for alcohol withdrawal tremors with acupuncture.
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Develop a plan with your doctor. If you are struggling with alcohol abuse and would like to quit, your doctor can help you find safe and effective ways to stop drinking. Make an appointment with your doctor to talk about the best approach for you based on your drinking habits and overall health. [17] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Ask your doctor about any questions you may have, such as:
- “Should I quit cold turkey, or is it safer to taper off?”
- “What are the major benefits of quitting?”
- “What are the risks and benefits of the different treatment options?”
- “How are my drinking habits affecting my health?”
- “What are the possible long-term effects if I don’t change my drinking habits?”
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Ask about an inpatient recovery center if your addiction is severe. Inpatient alcohol detox occurs inside a rehab facility, where doctors and staff will be on hand 24/7 to help you through your recovery. This detox can take anywhere from 5-14 days, and is most suitable for people with very severe alcoholism and withdrawal symptoms, such as delirium tremens. You can recover in a calming facility, letting you escape from the pressures of day-to-day life. [18] X Research source
- Some people can detox well in a facility, but have trouble when they return home. Having the support of family and friends can make this transition a little easier.
- Inpatient detox can also be quite expensive. Ask your insurance if they offer coverage, or inquire at the center to see if there’s a payment plan that allows you to pay the fee over a few months. [19]
X
Expert Source
Tiffany Douglass, MA
Substance Abuse Treatment Specialist Expert Interview. 10 March 2020. - You must see a doctor before heading to an inpatient detox facility. They will be able to determine whether it’s the right course of action for your recovery.
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Talk to your doctor about outpatient detox if your addiction is moderate. Outpatient detox treatment will require you to spend some time at a detox clinic every day. This can last for anywhere from several days to 2 weeks. You won’t have to stay overnight at the facility, but your medications and recovery progress will be closely supervised by the professionals there. Outpatient detox offers the benefit of being able to live at home and have more freedom, as well as being less expensive than inpatient detox. [20] X Research source
- However, outpatient detox also makes it easier to relapse and start drinking again. This is particularly hard if you have a difficult home life, or if another family member is an alcoholic. [21] X Research source
- Outpatient detox is only suitable for those with mild to moderate symptoms of alcoholism, who haven’t been drinking heavily or for a very long time.
- You must see a doctor before heading to an outpatient detox facility. They will be able to determine whether it’s the right course of action for your recovery.
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Ask your doctor about using medications to help you quit. If you are chemically dependent on alcohol, quitting or cutting back can be very challenging. Fortunately, there are medications available that can make the process easier. Talk to your doctor about trying one of these commonly prescribed medications: [22] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source
- Disulfiram (Antabuse) discourages drinking by interacting with alcohol to produce unpleasant physical reactions like nausea and headaches. However, this drug can also be addictive and should only be taken with very close doctor supervision.
- Naltrexone (Revia) prevents you from feeling the pleasant “buzz” that alcohol normally produces. Naltrexone also comes in an injected version called Vivitrol.
- Acamprosate (Campral) reduces alcohol cravings.
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Recognize the symptoms of deliriums tremens. Delirium tremens are similar to alcohol withdrawal shakes, but they affect your whole body and are much more severe. If you experience severe whole-body tremors after you stop drinking, along with other symptoms such as hallucinations, confusion, disorientation, and seizures, seek medical attention immediately. You may need blood drawn to see if liver damage is to blame.
- If you find yourself in the position of dealing with someone else experiencing delirium, it can be difficult to know what to do. Read up on how to care for someone with delirium so you know what to do.
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Watch for symptoms of cirrhosis of the liver. Cirrhosis of the liver occurs when scar tissue builds up on the liver and makes it difficult for it to function. Severe cirrhosis is life-threatening, but when caught in the early stages, liver damage can be treated and limited (though not cured). If you notice any symptoms, see a doctor right away. Symptoms include: [23] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source
- Fatigue
- Easy bleeding and bruising
- Yellow discoloration in your skin and eyes
- Spidery blood vessels
- Swelling in your legs
- Redness on your palms
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Get behavioral therapy. Behavioral therapy, or addiction counseling, can help you develop healthy coping strategies and attainable goals as you work toward quitting or cutting back your alcohol use. This type of therapy can also help you uncover and work through underlying issues that may be contributing to your drinking habits. [24] X Research source Ask your doctor to recommend a therapist who specializes in addiction or substance abuse.
- An addiction counselor can also assess your level of addiction and recommend the best treatment. [25]
X
Expert Source
Tiffany Douglass, MA
Substance Abuse Treatment Specialist Expert Interview. 10 March 2020.
- An addiction counselor can also assess your level of addiction and recommend the best treatment. [25]
X
Expert Source
Tiffany Douglass, MA
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Join a support group . Getting support from others who understand what you are going through is an important component of dealing with alcohol dependency. [26] X Expert Source Tiffany Douglass, MA
Substance Abuse Treatment Specialist Expert Interview. 10 March 2020. People in your support group can provide sympathy and friendship, and can also help hold you accountable or offer assistance if you find yourself in crisis or struggling with setbacks. Ask your doctor to recommend group therapy or peer-led support groups in your area. [27] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source- Do some research to see what groups are available, such as Alcoholics Anonymous.
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Seek support from family and friends. Your family and friends can play a key role in helping you successfully recover from alcohol abuse. [28] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source Let the people closest to you know that you are working to quit or cut back on your alcohol use. [29] X Expert Source Tiffany Douglass, MA
Substance Abuse Treatment Specialist Expert Interview. 10 March 2020. Ask them to respect your decision, and to help you by not drinking around you or putting pressure on you to drink in social situations. Identify a few close friends or family members that you can call on for support if you are in a bad place or struggling with the temptation to drink.- If you have any friends or relatives who regularly drink around you or do not respect your decision to quit or cut back, you may need to limit your time with those people.
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Expert Q&A
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QuestionWhat should I do if I feel the urge to drink?Tiffany Douglass is the Founder of Wellness Retreat Recovery Center, a JCAHO (Joint Commission on Accreditation of Healthcare Organizations) accredited drug and alcohol treatment program based in San Jose, California. She is also the Executive Director for Midland Tennessee at JourneyPure. She has over ten years of experience in substance abuse treatment and was appointed a Global Goodwill Ambassador in 2019 for her efforts in residential addiction treatment. Tiffany earned a BA in Psychology from Emory University in 2004 and an MA in Psychology with an emphasis on Organization Behavior and Program Evaluation from Claremont Graduate University in 2006.Try to distract yourself until the craving passes. You can exercise, go for a walk, take a bath, or do anything you find enjoyable that helps keep your mind off of drinking. Remember that you don't have to give in to your thoughts. They will go away.
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References
- ↑ https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250
- ↑ https://www.mayoclinic.org/drugs-supplements/baclofen-oral-route/description/drg-20067995
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/16490478
- ↑ https://www.mayoclinic.org/drugs-supplements/baclofen-oral-route/precautions/drg-20067995
- ↑ https://www.mayoclinic.org/drugs-supplements/baclofen-oral-route/precautions/drg-20067995
- ↑ https://www.mayoclinic.org/drugs-supplements/baclofen-oral-route/precautions/drg-20067995
- ↑ https://www.aafp.org/afp/2004/0315/p1443.html
- ↑ https://www.medicalnewstoday.com/articles/262809.php
- ↑ https://www.medicalnewstoday.com/articles/262809.php
- ↑ https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250
- ↑ https://www.cnn.com/2016/01/06/health/adult-coloring-books-popularity-mental-health/index.html
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/16740317
- ↑ https://americanaddictioncenters.org/therapy-treatment/yoga/
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106278/
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/12814907
- ↑ https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250
- ↑ https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250
- ↑ https://www.therecoveryvillage.com/alcohol-abuse/withdrawal-detox/inpatient-vs-outpatient-alcohol-detox-best/
- ↑ Tiffany Douglass, MA. Substance Abuse Treatment Specialist. Expert Interview. 10 March 2020.
- ↑ https://addictionblog.org/rehab/outpatient-rehab/outpatient-alcohol-detox-safety-and-duration/
- ↑ https://www.therecoveryvillage.com/alcohol-abuse/withdrawal-detox/inpatient-vs-outpatient-alcohol-detox-best/
- ↑ https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250
- ↑ https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487
- ↑ https://pubs.niaaa.nih.gov/publications/treatment/treatment.htm#chapter02
- ↑ Tiffany Douglass, MA. Substance Abuse Treatment Specialist. Expert Interview. 10 March 2020.
- ↑ Tiffany Douglass, MA. Substance Abuse Treatment Specialist. Expert Interview. 10 March 2020.
- ↑ https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2977912/
- ↑ Tiffany Douglass, MA. Substance Abuse Treatment Specialist. Expert Interview. 10 March 2020.
About This Article
Article Summary
X
Alcohol withdrawal shakes can be scary, but reducing your stress and anxiety can help quite a bit. While they normally go away on their own, if your shakes are severe or don’t stop, talk to your doctor right away. They may be able to prescribe something to help. Just be cautious when starting a new medication since it’s very easy to get addicted to withdrawal medications, especially when you’re quitting alcohol. To reduce your stress during withdrawal, try doing some light exercise, like going for a walk or riding your bike. You might also try journaling or spending some time with a supportive friend. Mindful meditation is another great way to reduce your anxiety and help prevent cravings and future relapses. To learn how to find an inpatient detox center, read more from our Medical co-author.
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