The choking game

What Is the choking game?

The choking game is a dangerous asphyxiation "game" that has been played by generations of kids. You may also hear it referred to as space monkey, fainting, pass out, black out, American dream, flatliner or flatline, space cowboy, knock out, gasp, rising sun, airplaning, Hawaiian or California High, breath play, choke out, cloud nine, dream or dreaming, funky chicken, ghost, hanging, hyperventilation, purple dragon, natural high, something dreaming, suffocation or suffocation roulette, teen choking or tingling.

The game involves compressing another person's chest or squeezing the neck, cutting off oxygen until he or she is light-headed. When pressure is released, the blood surges back into the brain and causes a "rush." Serious injury can result, such as:

• Bruises and concussions (from falling after passing out)
• Short-term memory loss
• Seizures, stroke
• Brain damage or brain death
• Retinal hemorrhaging

Unexpected death can and does occur.

There are no statistics available on how many kids play the choking game, but it's estimated that as many as 1,000 strangle themselves every year this way. The game has gotten a lot of press recently because of the more life-threatening turn it has taken:

• Use of ties such as belts, leashes and bungee cords (instead of the hands) to squeeze the neck
• Playing alone. With nobody to release pressure on the neck, a child can lose consciousness within one minute. After that, sagging body weight causes more constriction and futher decreases blood and oxygen flow to the brain. Death can happen in two to four minutes.

Signs & symptoms

One of the attractions of the choking game is the secrecy that surrounds it. Knowledge of it has always been passed peer-to-peer, older sibling to younger, without parents and other adults being aware. Today, word about the game spreads even more quickly via the internet, on websites and in chat rooms. Still, there are signs that can tell you if your child might be involved:

• Frequent, severe headaches
• Marks on the neck
• Red or bloodshot eyes
• Raspy breath
• Belts, bags and other ties left lying around the house
• An unusual need for privacy
• Websites or chat rooms where they use any of the words used to name these games

Who's at risk?

Kids 11 to 14 are most likely to play the choking game. They might just be curious, or they may be responding to peer pressure. Most know it's dangerous - that's part of the appeal at this risk-taking age - but they apparently don't know how lethal the game can be.

Many kids see the choking game as a safe, drug-free way to get high. In fact, players often are not kids who are rebellious, depressed, angry or otherwise at risk. Fatal cases commonly have involved energetic, high-achieving kids - especially boys - who were not cigarette, alcohol or drug users.

What you can do

Talk to your kids, and listen to them. They may already be talking about people they know who play the choking game, or times they've seen it played. You should also:

• Teach your children that this is not a game. Be very clear on how lethal it is.
• Monitor kids' activities, especially where they're unsupervised - alone or together - and have a chance to play the game.
• Discourage idle alone time by encouraging involvement activities: sports, clubs, music, volunteering, mentoring, etc.
• Ask your school to be more watchful of kids' behaviors in groups alone. Request programs that teach kids about the dangers of the game.

Priority Health members can check here for information on getting mental health assistance.