My son went thru rehab in March after going thru severe withdrawal – hallucinations, hospitalization, etc. Prior to going thru that, he had uncontrollably shaky hands.
Since leaving rehab in early April, I notice that his hands still shake – sometimes more, sometimes less, and never as much as when he was full-on drinking. But I wonder – does this mean that he is likely still drinking, or is this an after-effect that just takes time to go away (or may never go away despite staying sober)?
Reply
Uncontrollable shaking of hands is often referred to as “tremors.” Tremors are a common symptom of alcohol withdrawal. One of the reasons that this happens is because alcohol has a depressant effect on brain activity. The brain becomes used to a lower level of stimulation when someone is drinking regularly. Cessation of drinking can cause the brain to flood with activity. The brain may not be ready for this level of activity, and it can cause nervous system hyperactivity symptoms such as tremors. However, these withdrawal symptoms usually only last a week or less after drinking is stopped. It sounds like your son has been experiencing these symptoms longer than that and maybe even before he quit drinking.
If your son is still experiencing tremors, it could be that he has developed something called essential tremor. Essential tremor is a progressive neurological disorder featuring an uncontrollable shaking which can occur in the hands, jaw, feet, face, and tongue as well as other areas of the body. It gets worse throughout the life span. It is not known exactly what the cause of essential tremor is, and treatment options are limited.
A study done by Louis E et al in 2009 called “Population-based study of baseline ethanol consumption and risk for incident essential tremor” in the Journal of Neurology, Neurosurgery & Psychiatry found that ethanol (alcohol) can increase the chances of developing essential tremor. The study included 3,000 participants who had essential tremor. Fifty-six percent were daily drinkers. They also found that the more alcohol one drank on a daily basis, the greater the likelihood of essential tremor development. This finding could be explained in that ethanol is a known cerebellar toxin, and essential tremor is a disorder involving the cerebellum area of the brain.
It is also common for people with essential tremor to use alcohol to “medicate” themselves, because it temporarily decreases their shaking while intoxicated. For instance, they may drink before playing darts or something else that involved motor skills of the hands so that they are able to perform better. In addition, they may drink to lower the personal annoyance of the shaking or the embarrassment felt in front of others who may notice it. However, in the long run, alcohol has been found to worsen their condition and cause it to progress more rapidly.
So, no, the presence of tremors does not necessarily mean that your son is drinking again. I recommend that you consult a neurologist to have him assessed for essential tremor and discuss treatment options.
I am a Mental Health Counselor who is licensed in both New York (LMHC) and North Carolina (LCMHC). I have been working in the Mental Health field since 2015. I have worked in a residential setting, an outpatient program and an inpatient addictions program. I began working in Long Island, NY and then in Guelph, Ontario after moving to Canada. I have since settled in North Carolina. I have experience working with various stages of addiction, depression, anxiety, mood disorders, trauma, stages of life concerns and relationship concerns.
I tend to use a person-centered approach which simply means that I meet you where you are and work collaboratively to help you identify and work towards accomplishing goals. I will often pull from CBT when appropriate. I do encourage use of mindfulness and meditation and practice these skills in my own life. I believe in treating everyone with respect, sensitivity and compassion.
I recognize that reaching out for help is hard and commend you for taking the first step. We have professionals available who would be happy to help you move closer to reaching your goals related to your drinking concerns. You may reach these professionals by calling 877-322-2694.