The Deadly “Choking Game”

Posted: October 14, 2013 in Policing, Research
Tags: , , ,

This past weekend, I read the very tragic story of a 13-year-old boy who accidentally killed himself playing “The Choking Game,” different versions of which have been around for a long time. Essentially they involve someone (mainly kids) cutting off blood and oxygen flow to the brain for a short period as a way of experiencing a “high” of sorts.

Image courtesy of Vlado/

Image courtesy of Vlado/

Sometimes nothing bad happens as a result, but sometimes kids die. Solid statistics are hard to come by, but according to a CDC analysis (PDF), approximately 106 children between the ages of 6 and 19 years died in the U.S. from 1995 to 2007 as a result of some type of choking game.

CBS News Story on “The Choking Game”

According to the abstract of a 2010 study on this phenomenon in Academic Pediatrics, about 9% of middle and high school students reported participating in the choking game. More boys than girls engaged in such games, and older students more so than younger ones. The study also noted that:

Engaging in the choking game was highly associated with abuse of substances, suggesting that youth engage in the choking game for the thrill-seeking experience of brief euphoria, a drug-related feeling. To reduce the potentially fatal consequences associated with this behavior, pediatricians should screen youths and provide anticipatory guidance for higher-risk youths and their parents.

According to a 2007 article (PDF) published in the American Journal of Forensic Medicine and Pathology, the game has grown more dangerous in recent times due to “the increasing use of ligatures and ‘playing’ the game alone.”  The article also raised concerns that some death scenes are improperly classified as suicides when in fact death was caused by accidental means. Specifically, they noted that:

These games are clearly not new, but the terms of engagement have changed. Suicidal violence remains a leading cause of death in young adolescents, but it is clear that some, as yet undefined subset of cases may indeed be misclassified. Death scenes and autopsy findings in suicides and asphyxial games ending fatally do not appreciably differ. Investigators must ask the right questions of the right people to expose the possible role of such games in hanging deaths. This would include siblings and associates of the deceased if at all possible. Clues, albeit subtle, at death scenes may suggest the unintentional nature of the outcome of asphyxial activity (Emphasis added).

So, a heads up to law enforcement officers to get some training on this type of investigation, what to look for, and how to gather and analyze the evidence.

The best option, though, is to prevent this type of thing from happening in the first place. According to the CDC, warning signs of participation in the choking game include:

  • Discussion of the game or its aliases
  • Bloodshot eyes
  • Marks on the neck
  • Wearing high-necked shirts, even in warm weather
  • Frequent, severe headaches
  • Disorientation after spending time alone
  • Increased and uncharacteristic irritability or hostility
  • Ropes, scarves, and belts tied to bedroom furniture or doorknobs or found knotted on the floor
  • The unexplained presence of dog leashes, choke collars, bungee cords, etc.
  • Petechiae (pinpoint bleeding spots) under the skin of the face, especially the eyelids, or the conjunctiva (the lining of the eyelids and eyes)

So parents, get educated, talk with your kids about the choking game, and seek expert medical advice if you have concerns. Also, share this information with other parents to help prevent the senseless loss of life that can result from a child’s mistake.

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