February 14, 2008

Study Warns of Deaths from ‘Choking Game’

At least 82 youth have died as a result of playing what has been called "the choking game," according to a study released by the Centers for Disease Control and Prevention (CDC). Most of the fatalities are among boys aged 11 to 16.

The choking game involves intentionally trying to choke oneself or another in an effort to obtain a brief euphoric state or "high." Death or serious injury can result if strangulation is prolonged.

Eighty"“seven percent of these deaths were among males, and most fatalities occurred among those 11 years to 16 years old, with the average age of 13. Choking game deaths were identified in 31 states, the report said.

CDC found most of the deaths occurred when a child engaged in the choking game alone, and that most parents were unaware of the choking game prior to their child's death.

"Because most parents in the study had not heard of the choking game, we hope to raise awareness of the choking game among parents, health care providers, and educators, so they can recognize warning signs of the activity," said Robin L. Toblin, Ph.D., M.P.H., the study's lead author, in a CDC press release. "This is especially important because children themselves may not appreciate the dangers of this activity."

Three or fewer choking game"“related deaths per year were reported in the news media from 1995 to 2004, the report said. However, 22 deaths occurred in 2005, and 35 in 2006. Nine deaths occurred in the first 10 months of 2007, although the explanation for this decrease is unclear. The researchers said the study probably underestimates the number of deaths.

For this study, CDC analyzed media reports of deaths attributed to the choking game. Deaths were not included unless the report provided evidence that they were a result of the choking game.

"This report is an important first step in identifying the choking game as a public health problem," said Ileana Arias, Ph.D., director of CDC"²s Injury Center. "More research is needed to identify risk factors that may contribute to kids playing the choking game and to determine what may help to reduce this type of behavior."

Signs that a child may be engaging in the choking game include discussion of the game, including other terms used for it such as "pass"“out game" or "space monkey", bloodshot eyes, marks on the neck and severe headaches. Other signs include disorientation after spending time alone, ropes, scarves, and belts tied to bedroom furniture or doorknobs and unexplained presence of things like dog leashes, choke collars and bungee cords.

The agency said if parents believe their child is playing the choking game, they should speak to them about the life"“threatening dangers associated with it and seek additional help if necessary.

There are likely about 100 U.S. choking game deaths per year, said Dr. Tom Andrew, New Hampshire's chief medical examiner, in an Associated Press report. Dr. Andrew has been studying the phenomenon for several years.

Many coroners and medical examiners probably label the deaths as suicides because they don't have the time or resources to interview the victim's friends and look for alternate explanations, he said.

The full CDC publication is available here.