What Parents Need To Know About The Choking Game 

Some call it the “good kids’ high.” Children and teens are playing the so-called “choking game” – an activity in which they strangle themselves or friends for an instant shot of euphoria – believing it’s cheaper, quicker, easier and more legal than buying booze or pot. The game, which goes by many different names, is not new, but in an age of stupid teen challenges on social media, hospitals are warning parents about it once again.

The most important thing to know: Cutting off the brain’s oxygen supply, which happens when you’re suffocating, can be deadly. An organisation called G.A.S.P. (Game Adolescents Shouldn’t Play) has a heartbreaking album of kids who’ve lost their lives to the activity. In the United States, 82 children between the ages of 6 and 19 died from the choking game between 1995 and 2007, according to data from the Centres for Disease Control and Prevention.

Of course, the numbers hardly tell the whole story. Deaths by strangulation are often misclassified as suicide, and no public health databases currently monitor pass-out activities. And when kids sustain injuries related to strangulation or self-induced hypocapnia, which can include seizures, cognitive deficits, concussion, bone fractures, tongue biting and haemorrhaging of the eye, they’re unlikely to admit they were playing a game. In a recent Time story on the choking game, advocates report that “the problem may be worsening.”

It’s easy to dismiss warnings like this – but it’s important to be aware. Here’s what parents should know:

What Is This “Game” All About?

First, the choking game goes by all sorts of names. Here’s an incomplete list:

• Blackout
• Knockout
• Pass Out Challenge
• Faint Challenge
• Space Monkey
• Tap Out
• Funky Chicken
• Speed Dreaming
• Suffocation Roulette
• Flatliner
• Headrush

The exact rules differ. Some kids compete to see who can remain under a choke hold and resist passing out the longest. Others hold their breath and get punched in the chest by a friend. Some crouch down and try to breathe very quickly to induce hyperventilation, and then either get hugged tightly or pushed in the chest against a wall. Kids play in groups or alone. When by themselves, they might throttle themselves with ropes, cords or scarves. Nowadays, it’s all caught on video and posted on social media.

What Does It Feel Like?

As one teenage girl explains in a how-to video that I won’t link to here: “Suddenly, your fingertips will feel tingly … and you’ll get tingly all the way down. And suddenly, you won’t have control. You’ll want to videotape this because you won’t remember what you did if it works.”

According to Erik’s Cause, an organisation that raises awareness about pass-out games, two distinct feelings typically occur. The first is dizziness from the lack of blood and oxygen. The second is lightheadedness from blood rushing back to the brain. It is the same mechanism as the taboo sexual act of autoerotic asphyxiation, but performed for a different purpose. The game is always dangerous, but doing it alone is particularly so. “Because of lack of oxygen, you don’t even know that you may have fainted or worse – you are dying,” the folks at Erik’s Cause say in a video.

How Quickly Does Brain Damage Happen?

It depends on the person – usually, the brain can go up to three to six minutes without oxygen before lasting and irreversible damage occurs. After 10 minutes, a coma is almost inevitable. After 15 minutes, a person is very unlikely to regain any cognitive function.

Why Are Teens Doing This?

Part of it has to do with how their brains are wired. In teenagers, the frontal lobe (where decision-making happens) is not fully connected. They actually take a relatively long time to ponder the consequences of certain behaviours, but often ultimately decide the benefits outweigh the risks. So that’s a reason, along with curiosity, peer pressure and sometimes a genuine belief that it’s safe.

What Can Parents Do?

Know the warning signs that your child may be playing the choking game, which include bloodshot eyes, complaints of headaches, marks on their neck, unusual demands for privacy, or an unexplained presence of items like bungee cords or leashes. Oftentimes, though, there are no signs. Erik Robinson, the 12-year-old boy whose 2010 death inspired Erik’s Cause in the US, died after his first time playing the game. He tried it because he wanted to clear his mind about homework.

Talk to your kids about the dangers of the game without explaining how to play. “Never point to the neck because if you point to the neck you are unintentionally showing them how to do it,” write Stephanie Small and Judy Rogg, who have developed a school intervention program to educate parents, teachers and students about choking game. They urge parents to teach kids how to say no if anyone ever asks them to play.

How can I say NO?

Use humour. “No thanks, I need all the brain cells I’ve got.”

Walk away. Leave if people ask you to do it.

Give a reason. “No, it’s stupid and it can kill you.”

Strengh in numbers. Hang out with kids who won’t do this.

Avoid the situation. If you know kids that are doing it, don’t go with them

The good news about teenagers is that while they do really stupid things, there are ways to minimise the recklessness. It takes reminders – lots of them – to help them make better, safer decisions.