In a study published in the journal Pediatrics this month, researchers confirm what the mother of a 12-year-old already knew: Kids, for the most part in junior high, are still playing the choking game, and the choking game can be fatal. The researchers, based in Oregon, wanted to report on a common but little-known way for kids to get a legal high. Along with bath salts and synthetic marijuana, this legal high can result in brain damage, head trauma and death.

The choking game has been around for decades, but it may be one of those fads that skips generations. The 12-year-old’s mother hadn’t heard about it, but her own 85-year-old mother had: She remembered playing it when she was a kid. She was lucky. The day after her grandson learned the game from a schoolmate, he tried it at home. His mother says she “missed him by about 10 minutes.”

The study is one of the first to tackle the subject, and the first thing the researchers want everyone to understand is that it is no game. It works like this: A person, alone or with the help of another, strangles himself or allows himself to be strangled with a belt, rope or hands to cut off the oxygen and blood flow to the brain. The “fun” comes when the blood and oxygen rush back to the brain, triggering a euphoric high. Hyperventilating until the person passes out achieves the same results.

The organization Games Adolescents Shouldn’t Play, or GASP, has compiled data on the number of youths who have died as a result of the choking game. While no data is available for Oregon, between 1995 and 2004 Washington State logged 53 suicides and 32 accidental deaths from the choking game. Nationwide, that same period saw 650 suicides and 136 accidental deaths.

For the Pediatrics study, the researchers analyzed survey responses from about 5,400 eighth graders in Oregon to determine how prevalent the game is and what kind of kids engage in the risky behavior. They found that 6.1 percent — that is, 1 in 16 tweens or teens — had played the game at least once. Of those, 64 percent had played again after that first time, with 27 percent playing more than five times.

Who are these kids?

Hang gliding, drag racing, sky diving, bungee jumping, volcano boarding — people of all ages engage in extreme sports like these. The fun is in the danger, and, for some, the more danger the better. A group of Oregon researchers recently published a study about a dangerous activity that pre-teens and teens have been indulging in for decades: It is the choking game

The game goes by other names — fainting, pass out and knock out, among others — and it is inherently dangerous. Very dangerous, in fact: The objective is to induce cerebral hypoxia or, in layman’s terms, to cut off the oxygen flow to the brain. When the blood and oxygen rush back in, the player can experience a euphoric high.

If the blood and oxygen do not rush back in, the player can suffer a wide range of injuries, including brain damage and death. If it occurs in childbirth, cerebral hypoxia can cause cerebral palsy. Families sue doctors whose negligence has contributed to cerebral hypoxia and subsequent birth injuries.

Still, 6.1 percent of the Oregon eighth graders surveyed by the researchers said they had played the choking game. The researchers wanted to know if these kids shared any particular attribute, if there was any way to identify which kids are at risk.

Alcohol, drugs and tobacco use: 16 percent of the boys and 13 percent of girls who admitted to playing the game also admitted to using marijuana, drinking alcohol or smoking.

Sexual activity: While the data for boys is not available, the researchers found that the girls who were sexually active were four times as likely to play the choking game as their counterparts who had never been sexually active.

According to a mother whose son died when he tried to play the game at home, kids don’t understand that every time they do this they kill off brain cells. They don’t understand, she says, that the game is always risky, even if the player doesn’t suffer any immediate adverse effects.

The researchers discovered that 6.1 percent of the kids had played the game at least once. The next question, then, was to figure out who the kids are. They weren’t surprised by the results. They expected that kids who were participating in other risky behaviors would also be doing this. There are, however, plenty of “good” kids who play the game, too. For them, it’s a legal high, and the attitude is generally, “Hey, at least we’re not doing drugs.”

The real challenge is how to convince these kids that the game is dangerous. One key step is to teach pediatricians, school officials and parents what to look for. Kids who play the choking game will have bruising around the neck and bloodshot eyes; they will also complain about headaches.

As for letting kids know the dangers of the activity, a group of parents who have lost children to accidental strangulation hope the game can be included with lessons about drug and alcohol abuse and safe sex. The game has been around for years, and the game carries the same risk as those other activities.

Source:, “Who Is Playing the Choking Game?” Carrie Gann, April 15, 2012