The Choking Game

From 1995, the Centers of Disease and Control and Prevention have followed an activity called the Choking Game. It is also known as Space Monkey, the Black Out Game, the Scarf Game, Pass Out, or Choke. As the names suggest, it involves a “player” strangling himself, in order, to experience a source of euphoria. The names applied to this risky activity are misnomers. There is nothing playful or sporting involved in this risky behavior. If one were to properly name this perilous action, it should be called Brain death. The deprivation of oxygen by asphyxia can cause a euphoric state, but sadly, many a child has died and others have suffered severe brain damage trying to attain this euphoric state.

The Choking Game is not to be mistaken for autoerotic asphyxia because the intent is to gain a high without sexual stimulation. The average age of a child participating in Choke is 13. Most “players” are males between the ages of 11 through 16 years of age. Here are some statistics:

1.    From 1995 to 2008, 82 deaths have been documented.

2.    2005 had 22 fatalities.

3.    2006 had 30 fatalities.

There may be more deaths that have not been attributed to Choke because some deaths may be construed as suicide. Usually, a suicide accompanies a good-bye note.

What is further disturbing about this risky activity is that many parents do not realize their children are “playing” Choke.  Studies of 39 out of 42 parents of Choke game victims were unaware of their child’s participation. 39 of these parents discovered their child’s risky behavior upon the child’s time of death.

The CDC has been following risky behaviors in children with the Youth Risk Behavior Survey since 1991. Consequently, the CDC asked 114 schools in Oregon during the Oregon Health Teen Survey to inquire about the choke game. Here are the results of the 2008 survey:

1.    36.2% of children have heard of Choke

2.    30.4% knew a participant

3.    5.7% had tried to play Choke

4.    2.6% helped someone participate

5.    23% of the children questioned did not respond to the question regarding Choke. The CDC suggests that the lack of response is directly associated with an increase in these children participating in Choke.

A study in Texas and Ontario, Canada found that 40% of youths surveyed thought there was no health risk associated with Choke.

The other problem with this risky behavior stems from the opinion, “If you talk about Choke to children, then you are inadvertently teaching them how to play.” Children learn from other children. The internet is another educator. Having used a common search engine, I discovered several websites regarding Choke. Some internet sites pay tribute to the fallen victims. Some sites actually showed the brain damaged children, who participated in Choke. One could extrapolate how to “play” Choke based upon several websites.

Ignoring this risky behavior does not diminish its popularity or decrease the morbidity and mortality associated with this game. For instance, 1/3 of patient care providers were unaware of this game. It would appear that children seem to be more familiar with this game than adults.

Here are some signs of Choke:

1.    Blood shot eyes

2.    Marks on the neck

3.    Frequent headaches

4.    Disorientation after spending time alone

5.    Scarves on bedroom floors

6.    Belts tied to furniture or doorknobs

Parents, teachers, and health care professionals need to discuss this openly with children. After all, pregnancy, sexual activity, prescriptive and non prescriptive drug use, and alcohol are incorporated into public heath education. The discussion of these previously mentioned subjects does not increase those kinds of activities. The argument for openly discussing risky behaviors causing more risky behavior is passé. There is too much information that is easily accessible to youth that is often incorrect. A proper forum is needed to properly address the health concern related to Choke. Open lines of communication are imperative in order to teach children regardless of topic.