07/03/2010 05:12 am ET | Updated Nov 17, 2011

Parents, Do You Know About the Deadly Choking Game?

If you are a parent of a pre-teen or teen, knowing about the "Choking Game" could save your child's life. What is commonly referred to as the Choking Game is also known as Pass-out, Tingling, Roulette, Black-out, Flatliner, Suffocation, California High, Space Cowboy, Rising Sun and Airplaner, among others. The goal of this "game" is to choke yourself on purpose in order to deprive the brain of oxygen just to the point before passing out in order to achieve a "high."

I was saddened beyond words when I read that a 12-year-old boy from southern California had died this week from choking himself and then passing out and losing consciousness which resulted in his death. My first thought was, "What's wrong with these kids? What is going on?" But then, suddenly, I had a vivid memory of a time when I was 12 years old. The following story is why this boy's death hit too close to home.

I was 12 years old. I was sitting around with a group of kids who would come every summer with their parents and rent cottages on Cape Cod from my grandparents. We had grown up spending many happy summers together. One of the kids in the room asked us if we had heard about a way of getting out of school just by bending over at the waist and breathing heavy. What I didn't know then was that he was teaching us how to hyperventilate, and then you stand up really fast, while at the same time squeezing yourself really tight (like a bear hug) and then you let go. The goal was to faint. This, he assured us, was a sure-fire way of getting out of school. I tried it, I felt tingly and very dizzy, but didn't pass out. Luckily, I didn't get "high" and never tried it again. I had no idea those many decades ago that I had just tried a watered-down version of the choking game.

Let me assure those of you who are thinking, "Yeah, but only troubled kids try this craziness. My child knows better." Don't be so sure. I WAS that good kid, the kid that did well in school, loved her church, had ballet lessons, never talked back to adults, was loved by all my teachers, and wouldn't even swear for fear of disappointing my parents. Hell, I hadn't even kissed a boy or tried a cigarette, never mind anything more dangerous! When my friends were sneaking beer I was watching off in the background.

This is NOT a new fad. This behavior has been around for decades, but now it has come into popularity. It gives the "good kids" a chance to get "high" without the risks of getting caught with alcohol or drugs. The average age of kids doing the choking game is 9 -16 years old, and 250- 1,000 kids die in the U.S. and Canada each year from it. It's difficult to get accurate numbers to assess its lethality since many are ruled as suicides.

But, as it seems with so many things today, the "game" has been amped up a few notches. Twelve and 13-year-old children, boys and girls alike, are "choking out" by applying pressure to the carotid artery of friends and of themselves, or bear-hugging around the chest thereby cutting off blood supply to the brain. The brain is then deprived of oxygen, resulting in brain cell death by the millions, and in some cases, brain damage, or death.

The thrill of this activity causes people's sympathetic nervous system, or the "flight and fight" part to be activated. The pituitary and hypothalamus release natural endogenous opiates or 'heroin' like substance. These feel good chemicals cause warm-fuzzy feelings. As the blood carrying oxygen to the brain is decreased either reversible functional/physiological changes may occur or non-reversible structural/anatomical change may occur. The exact point at which this decreased cerebral blood flow will cause permanent changes or transient changes is fleeting. There is no way to know when this magic moment is, and getting it wrong will end in an ischemic stroke, seizure or death.

This behavior can be very addictive. Some kids start out with friends and end up choking out alone. They can be dead before anyone knows they've even passed out.

Signs someone may be playing the choking game:

• Blood shot eyes
• Frequent or unusual headaches
• Marks on neck
• Locked doors
• Knots tied in room
• Wear marks on bedposts, closet rods, etc.

The choking game is different than auto-erotic asphyxiation. In the latter, the goal is sexual release in addition to the "high." Children participating in the choking game are not sexual deviants. They are simply ignorant of the chance they are taking with their life at time in their life when the tendency to feel invincible is natural.

This article is meant to be informative and is in no way intended to provoke someone into engaging in this behavior. For information on how to talk to your child about it, or how to talk to a friend if you know someone who'd doing it, go to Don't wait for your child to talk to you about it. They need to be educated by someone who loves them before they become seduced by someone who isn't scared and convinces them that near-suffocation is only a game.