Alcoholism has a tendency to sneak up on a person. You may be a high functioning alcoholic who manages to sail through your days being productive and socially engaged without tipping off anyone that you struggle with alcohol abuse. But as sure as the sun comes out tomorrow, eventually alcoholism rears its ugly head and blows your cover.
Hand tremors are one of the common signs of alcohol addiction that is difficult to hide. This shaking hands sign of alcoholism may begin subtly, being felt only by you and not visible to coworkers or family members. Over time, however, as the disease becomes more acute, hand tremors will give away your secret. This may prompt an honest self-examination of the severity of your problem with alcohol, hopefully resulting in seeking treatment.
The Three Stages of Alcoholism
It is still not understood why some individuals can drink heavily and never become alcoholic, while others quickly become enslaved by alcohol. Factors such as a family history of alcoholism, attempts to self-medicate depression or anxiety, traumatic life events that are difficult to overcome, and excessive or chronic stress are seen as contributing factors.
Alcoholism proceeds in three stages, although the length of time at any of the stages can vary significantly. These stages are:
- Early stage alcoholism. During this stage alcohol use becomes more regular, versus social occasions only. The individual may use alcohol to self-medicate a mental health disorder such as depression or anxiety, or to help battle insomnia, and consistently lean on it. During this phase, the individual may lie about their alcohol consumption or hide it from family members. Meanwhile, the body is becoming more tolerant of the alcohol and begins to demand higher levels of consumption to get the relaxation or euphoric effects they originally sought.
- Middle stage alcoholism. At this stage it becomes evident to others that there is a problem with alcohol. The individual may experience blackouts after excessive drinking. They may experience mood swings, irritability, and stomach distress. Bloating and weight gain or loss are also signs of middle stage alcoholism. Alcohol cravings become intensified, and the individual becomes obsessed about when they can drink next. At this stage, alcoholism can lead to relationship problems, financial problems due to job loss, and possibly a DUI. When attempting to withhold alcohol, withdrawal symptoms, including the shaking hands sign of alcoholism, will break through.
- End stage alcoholism. At the final stage of alcoholism the individual has no control over their drinking at all. They wake up sick and have to immediately begin drinking in the morning, continuing throughout the day to ward off withdrawal symptoms. Serious medical conditions have developed, including possibly cirrhosis of the liver, pancreatitis, hepatitis, or heart conditions. End stage alcoholics are also more prone to falls and accidents. Cognitive problems become pronounced, with signs of dementia emerging, and psychological symptoms, such as paranoia and fear, often occur. Suicide is a concern in end stage alcoholism as well.
What Causes Alcoholics to Shake?
Once the brain has been altered in response to the consistent effects of alcohol consumption the individual becomes chemically dependent. This means that attempts to quit drinking, or even just cutting back, may be met with withdrawal symptoms. Withdrawal symptoms are the result of the body attempting to function without the expected alcohol intake that it has become accustomed to.
The shaking hands of alcoholism represent one of the visible signs of someone’s alcoholism. The tremors are typically seen in the hands, but they can also affect the entire body. It is thought that the tremors are caused by the absence of the depressant (alcohol) that has been having a regular sedative effect on the central nervous system. When the alcohol is withheld the messaging between the brain and the central nervous system that controls muscle movement is disrupted.
Other Alcohol Withdrawal Symptoms
In addition to the hand tremors or shaking, there are several other highly unpleasant withdrawal symptoms that commence within 8 hours of the last alcoholic drink. The severity of the withdrawal symptoms depends on the level of regular alcohol consumption and the length of time the individual has been a heavy drinker.
Withdrawal symptoms include:
- Nausea and vomiting
- Clammy skin
- Hand tremors
- Rapid heartbeat
- Profuse sweating
Acute Alcohol Withdrawal Syndrome
The detox and withdrawal process can take a sudden turn at about day 3 or 4, segueing into an acute alcohol withdrawal syndrome condition called the delirium tremens (DTs). The DTs represents the most extreme form of alcohol withdrawal which has the potential to be fatal. Because it is difficult to predict which individuals might develop the DTs, a medically supervised detox is always recommended for alcohol detox and withdrawal.
The DTs is characterized by a rapid onset of mental confusion, however care should be taken to rule out other potential causes of this change. Those might include pancreatitis, alcoholic hepatitis, or electrolyte abnormalities.
Symptoms of the DTs include:
- Global confusion
- Uncontrollable tremors
- Hallucinations, both auditory and visual
- Profuse sweating
- High blood pressure
- Rapid heart rate
- Anxiety, panic attacks
- Feelings of impending death
Treatment for the DTs involves rapid medical intervention using benzodiazepine medication in doses that lead to a state of light sleeping. An antipsychotic drug, haloperidol, is sometimes prescribed for managing the symptoms of psychosis. Intravenous hydration that includes thiamine is a common intervention as well.
The DTs will impact 5-10% of individuals undergoing detox and withdrawal, with a 15% mortality rate among this cohort. Although it is hard to know which individuals might experience the DTs, it is most common in those with a long history of heavy alcohol consumption.
Medical Detox for Alcoholism
When the individual is ready to get treatment for an alcohol addiction it is essential that they enroll in a medically monitored detox program. Alcohol withdrawals can become a serious health emergency in some cases, but it isn’t always easy to predict these events. A medical detox provides the support and medical interventions needed to successfully complete the detox program and enter treatment.
During the medical detox, the individual’s vital signs will be monitored throughout, as these can foretell the potential for the delirium tremors developing, which affects about 5% of those who undergo alcohol detox. Through the detox process, the individual will be aided with benzodiazepines to prevent seizure, assist with anxiety symptoms, and aid sleep. Other medications will be administered as needed for the nausea or stomach distress.
Immediately following the medical detox, the individual should begin the addiction treatment program that will help him or her change addictive behaviors that have become hardwired over time. Cognitive behavioral therapy is a short-term therapy that is very effective with treating addictive behaviors. CBT helps clients identify the misguided thoughts that lead reflexively to alcohol use, and changing these disordered thought and behavior patterns, the individual gains control over their behaviors.
Comprehensive Treatment for Alcoholism
Once the alcohol detox is completed the individual will enroll in an addiction treatment program. This is a necessary step in alcoholism recovery, as the chronic intake of alcohol has affected neurotransmitter systems in the brain, including serotonin and dopamine receptors, increased activation of the GABA receptor producing increased GABA inhibition, and affecting the NMDA glutamate receptor. These are structural changes in brain functioning that have resulted from long-term alcohol abuse. Making behavioral changes in recovery is dependent on intensive psychotherapy, among other interventions.
To effectively treat the addiction behaviors, during which distortions in thought-behavior patterns will be incrementally shifted toward healthy patterns, alcohol recovery treatment includes:
- Psychotherapy. Provided in both individual and group formats, the most effective forms of psychotherapy for treating alcohol addiction include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and contingency management (CM).
- Medication management. Medication assisted-treatment (MAT) using naltrexone for recovery support may be indicated.
- Education. Extensive education about the affects of alcohol on brain functions and how addiction develops can be a deterrent to recurrent alcohol use. Classes include planning strategies for relapse prevention, which involves identifying triggers and planning proactive actions to avoid relapse.
- Holistic activities. Increasingly, holistic activities are being woven into the recovery plan. These are activities that teach individuals in recovery how to regulate stress and may include yoga, massage therapy, mindfulness training, guided meditation, art therapy, journaling, and regular exercise.
- Recovery groups. Many rehabs incorporate Alcoholics Anonymous 12-step programming into the overall treatment program, where others use the non 12-step concept recovery group. Both are helpful in providing social support.
Aftercare Services Following Alcohol Rehab
Once an individual has successfully completed an inpatient or outpatient rehab program, it is important to continue to engage in important services that can help support recovery. These include:
- Sober living housing. Sober living is an excellent additional layer of support for individuals who do not have a supportive home environment to return to.
- Outpatient therapy. Ongoing outpatient therapy provides the support needed in early recovery as the individual encounters triggers or stressors that may threaten sobriety.
- Recovery meetings. Whether the individual prefers A.A.’s 12-step program or a non-12-step program such as SMART Recovery, being actively engaged in a recovery community is an important protective factor for maintaining sobriety.
Getting Treatment for Alcohol Addiction
Capo By the Sea is an elite addiction recovery program, serving individuals in Southern California with a desire to overcome an alcohol or drug addiction. Capo By the Sea offers a unique blend of beautiful location, a premier clinical staff, luxury accommodations, and holistic spa-like activities that makes rehab much more palatable. People choose Capo By the Sea because its staff exudes a sense of compassion and expertise, and treatment is obtained within a tranquil seaside setting. If you are experiencing the shaking hands of alcoholism, it is time to address the problem and get the help you need and deserve. For more information about our program, please contact Capo By the Sea today at 888-529-2114.