Choking Game – Not A Game At All

Choking Game - Not A Game At All

Dr. Todd Huffman, January 2010

In January, the country was shocked by a finding of the Oregon Healthy Teens Survey, conducted and released by the Oregon Department of Human Services, Division of Public Health.

Among many discoveries, the Survey found that as many as 2600 eighth graders in the state have participated in the “choking game”, also sometimes called Pass-Out, Space Monkey, Flat Liner, Blackout, and the Fainting Game, among other aliases. The survey also found that one in three eighth graders had heard of someone participating in this activity, and that 6 percent reported participating themselves.

The “choking game” is not a game at all – just an act of suffocating on purpose. Adolescents cut off the flow of blood to the brain, in exchange for a few seconds of feeling lightheaded, which can cause a brief “high”, or feeling of euphoria.

Some strangle themselves with a belt, rope, tie, scarf or similar item, or teens strangle each other using their bare hands. Still others push on their chest, or hyperventilate.

When the pressure is released, blood that was blocked up floods the brain all at once. This sets off a warm and fuzzy feeling. If the strangulation or pressure is held too long, even as little as one to two minutes, passing out is induced due to low blood flow and therefore oxygen to the brain. Serious brain injury resulting in long-term disability or even death may occur if strangulation is prolonged more than two to three minutes.

Make no mistake that deaths do occur. There were at least 82 pre-teen and teen deaths nationwide during the period from 1995 to 2007 caused by this awful “game”. Many adolescent health experts believe that the death toll is much higher, with many of the accidental deaths reported as suicides.

Boys are much more likely to participate in, and to die from, the choking game than girls. Nearly nine in ten of the known deaths from the game were boys. Most of the deaths were in children ages 11 to 16 years, and nearly all of the children who died were playing the game alone, when nobody’s around to help if passing out occurs.

In most instances, the strangulation is a group activity, though the use of a ligature as a solo venture appears to be a growing practice. Whether the overall number of pre-teens and teens playing the choking game is increasing is uncertain, though presumed, owing to greater media attention given and to Internet websites and YouTube clips offering game instructions.

Common fallacies held by pre-teens and teens about the game include the belief that because it’s a group activity, it’s safe, and the belief that because it’s just passing out, no one is harmed since no one ever dies from passing out. By becoming more informed about the choking game, parents and physicians and educators can help correct such misunderstandings.

Parents, educators, health-care providers, or peers may observe any of the following signs that can indicate a child has been involved in the choking game:

• Discussion of the game or its aliases
• Bloodshot eyes, or pinpoint bleeding spots under the skin on the face, especially the eyelids
• Marks on the neck (bruises, rope burns)
• Wearing high-necked shirts, even in warm weather
• Frequent, severe headaches
• Disorientation after spending time alone
• Ropes, scarves, or belts tied to bedroom furniture or doorknobs, or found knotted on the floor
• The unexplained presence of dog leashes, choke collars, bungee cords etc. in backpacks or in the bedroom

Participants in the choking game are generally high-achieving in academics, activities and sports, and don’t want to risk getting caught with drugs or alcohol. Some do it for the high, which can become addictive. Others do it because it’s “cool” and risky.

Most children who have died from this activity were afterward reported as active, intelligent, stable kids. Parents need remember that children, pre-teens, and even many younger teens have no concept of their own mortality – they truly believe nothing can hurt them.

Asphyxiation games have long been popular with pre-teens and teens, but in modern times the ubiquity of new forms of media allows children and teens greater access to written and video instructions to new methods of this dangerous form of play.

Talk to the children in your life about the choking game. Remember that children who have played this activity are nearly always unaware that the activity can kill them or leave them brain damaged. Be alert for signs of participation by pre-teens and teens in strangulation activities.

Finally, talk to parents and everyone you know who works with children. Warn them about the choking game, about this dangerous and potentially fatal activity.