Medically Reviewed by Dr. Mohammed Saeed, MD.
For those recovering from an alcohol abuse disorder, making it through the weeks of withdrawal symptoms can be one of the biggest hurdles to overcome. One symptom that can be quite frightening — and especially dangerous, if not medically supervised — is shaking or tremors as a result of stopping alcohol consumption abruptly.
Body or hand shakes will usually set in two or more days after alcohol consumption stops. For some alcoholics in detox, these shakes are barely noticeable. For others, however, they can be quite a bit more dramatic and even interfere with daily living. So, just how long should you expect your particular symptoms to last?
The duration of your shakes and tremors can be dependant on a few different factors. Everyone will experience recovery and withdrawal a little bit differently, depending on the circumstances and severity of their addiction. Sometimes, recovering alcoholics experience no shakes at all throughout the detox period. In some cases, body shakes last until the withdrawal process is complete, which can be anywhere from 1-2 weeks, on average.
If you’ve been experiencing fear or intense anxiety as you move forward with detox, these shakes can be even more intense. Those who have struggled with long-term, chronic alcohol dependency may experience shakes throughout the entire withdrawal process and sometimes even weeks beyond that.
How Long Does Delirium Tremens Last?
Approximately 5% of recovering alcoholics will develop a condition known as Delirium Tremens or DT. This is a neurological disorder that arises as a result of alcohol withdrawal and can present symptoms such as hallucinations, confusion, and intense whole-body tremors that may last well beyond the detoxification period.
Similar to the more common withdrawal shakes, Delirium Tremens will generally begin presenting symptoms after 2 to 4 days, but can sometimes take up to a few weeks to fully develop. DT is extremely dangerous and will often require 100% medically supervised detox, including heart rate and blood pressure monitoring and, sometimes, even emergency life support.
Those affected by DT during the withdrawal period may develop permanent brain damage or neurological disorders if not supervised and treated by a team of medical professionals. Because it may be difficult to predict the intensity and duration of alcohol withdrawal symptoms, including shakes and tremors, it is always advised that alcoholics seek clinical recovery to best manage and monitor symptoms that may evolve into more serious conditions.
What Are The Signs and Symptoms of Delirium Tremens?
Even though delirium tremens begin after detoxification, this symptom of alcohol withdrawal doesn’t occur right away. Typically, when you quit using alcohol, mild symptoms of withdrawal occur first. These symptoms, which often begin 8 to 24 hours after your last drink, generally include insomnia, headaches, fatigue, and increased anxiety.
As the withdrawal process continues, the symptoms can become more severe. These moderate symptoms make up the second stage of alcohol withdrawal and typically include excessive sweating, nausea, increased blood pressure, and hallucinations. After this, more life-threatening symptoms such as chest pain, seizures, or delirium tremens can occur.
Delirium tremens (DT) is the most severe form of alcohol withdrawal. This stage of alcohol withdrawal, which can begin anywhere from 2 to 10 days after the last drink, can be fatal. The primary symptoms of DT, also known as delirium withdrawal, is a rapid onset of severe confusion and brain changes that affect blood circulation and breathing.
Delirium tremens happens when the brain is unable to adjust its chemical balance after you quit consuming alcohol. Heavy, chronic drinking interferes with the body’s ability to regulate the neurotransmitters gamma-aminobutyric acid (GABA) and glutamate. Glutamate excites the brain, while GABA helps calm it down. Excessive drinking reduces GABA, making the brain more sensitive to glutamate. When you stop drinking alcohol, the brain doesn’t have enough GABA neurotransmitters to produce a calming effect. This over-excitement can cause symptoms of withdrawal and delirium tremens.
During DT, the brain may struggle to maintain basic functions such as breathing, circulation, and temperature control. As a result, less blood flows to the brain, which increases the risk of heart attack, stroke, or even death.
Other symptoms of delirium tremens can include:
- Pale skin
- Loss of consciousness
- Shallow breathing
- Severe confusion
- Extreme hyperactivity
- Sleep disturbances
- Rapid heartbeat
- Excessive sweating
- Violent muscle contractions
- Nervous or angry behavior
- Sensitivity to light, touch, or sound
- Tremors or shaking of the hands and feet
- Deep sleep that lasts for a day or longer
Even though delirium tremens symptoms can resolve in a few days, they often require medical attention.
What Should I Do If I Suspect I May Have Delirium Tremens?
Since many of the symptoms associated with DT can be life-threatening, delirium tremens is considered a medical emergency. In fact, approximately 37% of untreated delirium tremens cases can be fatal. If you suspect you think you may be experiencing DT, call 911 right away.
Because of the extreme agitation coupled with the high potential for fatal outcomes, DT is best treated in an intensive care unit. There, medical personnel can monitor your vital signs. To help prevent any further medical emergencies, your healthcare team will keep a close watch on your:
- Blood pressure
- Breathing rate
- Body fluid levels
- Blood chemistry results such as your electrolyte levels
Medical personnel may also give you medication to help you stay calm and relaxed until delirium tremens dissipates. Typically, the medication you receive will also help treat:
- Any co-occurring mental disorders
After you recover from delirium tremens symptoms, your medical care team may suggest treatment to help you avoid alcohol use long-term. The type of treatment program you choose to enroll in is up to you, but some common options to consider include:
- Counseling. Any type of behavioral therapy can help you avoid alcohol abuse, but some of the most common behavioral therapies associated with alcoholism include cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), 12 step facilitation, and motivational interviewing (MI). CBT can help you challenge harmful beliefs, confront fears, and learn healthy strategies to avoid alcohol and drugs. DBT can help you regulate challenging emotions, handle distressing situations, and live intentionally rather than impulsively. Motivational interviewing can help boost your self-efficacy and 12-step facilitation can help you maintain sobriety.
- Support groups such as Alcoholics Anonymous. In addition to helping you connect with like-minded individuals, support groups can help prevent isolation, combat depression, encourage honest communication, and help you stay motivated.
- Abstinence, or a total and lifelong avoidance of alcohol. Although abstinence can be challenging at first, avoiding alcohol completely can increase your energy, improve your sleeping habits, strengthen your immune system, and enhance your overall well-being.
The Importance of Medically Supervised Alcohol Detox
Although beneficial, detox from alcohol can be dangerous. Low electrolyte levels can cause cardiac complications such as arrhythmias and heart attacks. Dehydration can cause mental confusion and disrupt autonomic functions in the central nervous system that regulate breathing, blood pressure, and digestion. High levels of anxiety and depression can lead to self-harm and suicidal ideations. Luckily, medically supervised detox can help ease symptoms of withdrawal, minimize harm, and address medical emergencies related to alcohol detox.
In a medically supervised detox program, a team of healthcare professionals will watch over you as your body processes the remaining toxins from alcohol. They will also give you medications that can help ease physical pain, stabilize your mood, combat depression, and help you sleep better. Your medical care team will also provide you with the right amount of fluids to prevent and reverse dehydration and ensure you have balanced meals that can help restore your nutrition levels.
You should also consider medical detox for alcohol abuse because this process:
- Happens in a non-judgemental, encouraging, safe, supportive, and calming environment
- Allows healthcare professionals to ensure your safety and prevent medical emergencies
- Offers you medication that can relieve symptoms of withdrawal and cravings
- Can help address any co-occurring mental health conditions you may be experiencing
- Can help reduce your risk of relapse
Alcohol detox is a necessary step towards sobriety, but it can be challenging. Medically supervised detox can help ease the process and prepare you for addiction treatment.