Many people associate alcohol abuse with involuntary shaking—known as “essential tremors” in the medical community. In fact, these tremors have been linked to alcohol abuse for decades. But why?
What is it about alcohol that causes shaking? And if you experience tremors after drinking, what can you do about it?
Why Do I Shake After Drinking Too Much?
The short answer is that shakiness after drinking is generally the result of withdrawal from alcohol. Withdrawal symptoms can occur the morning after drinking, but shaking is most likely to occur when someone who drinks heavily stops using alcohol.
Although everyone handles alcohol differently, tremors rarely occur when a person is actively drinking.
How Much Drinking Causes Shaking?
The exact level of drinking that leads to withdrawal symptoms varies by person. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines heavy drinking as over four drinks per day for men, and over three per day for women. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines it as binge drinking at least five times per month.
If you drink at or above these levels—or even drink an excessive amount of alcohol in one night—you may experience withdrawal symptoms once the alcohol leaves your body. These symptoms may include tremors.
What Is A Tremor?
Tremors are defined by the National Institutes of Health (NIH) as an “involuntary, rhythmic muscle contraction leading to shaking movements in one or more parts of the body.” They tend to occur sporadically, and increase in severity the more a person abuses alcohol.
Typically, tremors are more annoying than life-threatening. But they can be debilitating if they affect activities such as shaving, eating, or writing. Essential tremors are not only caused by alcohol. Medications, brain damage, and chronic conditions like Parkinson’s can also cause involuntary shaking.
What Causes Tremors From Alcohol?
What causes shaky hands after drinking alcohol? The exact cause of tremors is still unknown. But in the case of alcohol-related shaking, part of the issue may be the sedative effects of drinking alcohol, and how that conditions your nervous system.
Alcohol can imitate or increase the effects of GABA, a neurotransmitter that calms your neuron activity. Drinking to excess can therefore over-inhibit your system—causing you to black out, feel numb, or experience euphoria. This can also affect your motor control—resulting in slurred speech or clumsier movements.
Once the effects of alcohol wear off, the opposite thing can happen to your neurons—they can become overstimulated until your system rebalances itself. One consequence is that some reflex pathways can fire sporadically, causing tremors. This is one of the main answers to the common question, “Why do alcoholics shake?”
What Helps With “The Shakes” After Drinking?
If you often experience shakiness after drinking alcohol, there are several solutions. One good first step is to check in with yourself about your alcohol consumption. If you notice yourself drinking often, tremors from alcohol might be a sign that it’s time to cut back.
Online programs like Ria Health can help you assess your drinking levels, and reduce or quit from the comfort of home. For many, drinking-related tremors tend to resolve themselves once detox from alcohol is complete.
There are several medications that can ease alcohol withdrawal symptoms. Anti-craving medications such as gabapentin can reduce tremors and anxiety as you cut back.
- Milanov I et al. Alcohol withdrawal tremor. Electromyogr Clin Neurophysiol. Jan-Feb 1996; 36(1): 15-20. Accessed January 4, 2021.
- National Institute on Alcohol Abuse and Alcoholism. Drinking Levels Defined. Accessed January 4, 2021.
- National Institute of Neurological Disorders and Stroke. Tremor Fact Sheet. Accessed January 4, 2021.
- Deuschl G et al. The pathophysiology of tremor. Muscle and Nerve. May 2001; 24(6): 716-735. Accessed January 4, 2021.
- Sanna E et al. Changes in GABAA Receptor Gene Expression Associated with Selective Alterations in Receptor Function and Pharmacology after Ethanol Withdrawal. J Neurosci. Dec 2003; 23(37): 11711–11724. Accessed January 4, 2021.