THE CHOKING GAME ... For Parents


By Julie Rosenbluth, M.P.H., CHES

Reprint right granted by Ms. Rosenbluth

You may have seen in recent headlines citing the death of several young children and teens caused by "the Choking Game". Also known as the "pass out game", "dreaming", "pass out", or "ghost", you might even remember it or something like it from your childhood, as the concept has been around for a while. The primary goal is to cause a friend to literally choke or lose breath and feel a consciousness altering experience or a "high". You may have thought it was a harmless game played at sleep-over parties or play dates but what you didn't know is how dangerous and possibly deadly this game could get.


The Choking Game, as it has come to be called, is a game children play by compressing a friend's chest or squeezing their neck to cut off the flow of oxygen. In the first step, the person being choked will feel light-headed due to the reduced blood flow, and lack of oxygen to the brain, causing a perceived "high". Once the pressure to the chest or neck has been lifted the surge of blood back into the brain creates a perceived "rush". The recent deaths and brain damage cases in the media are the result of the "game" gone awry. According to experts, a child playing this game could lose consciousness within a minute and die in as little as 2-4 minutes as the weight of their body further constricts blood and oxygen to the brain. Deaths or brain damage can occur when children try to induce the high by themselves. In many of these cases, children are constricting themselves with ties or belts. When the flow of oxygen is cut off they unintentionally pass out leaving no one to loosen the "noose" they have created and save them. The risk of brain damage or death is compounded when there is no one to relieve pressure, reintroduce the flow of oxygen and restore a child to consciousness. When first discovered these cases are often marked a suicide when in fact these children had no intention of killing themselves and were just "playing a game". Even children who play the game among friends are still at risk for permanent brain damage, harm to the retina, accidental fall from passing out, and death. In addition, if the child's partner accidentally squeezes a small group of nerve cells in the neck, the heart can come to a complete stop.


The age range of kids who most often participate in this behavior is 9-14 years. Many pre-teens and teens participate in this lethal game out of curiosity -- not rebellion, depression or anger. The game may be played by kids who are not outwardly at-risk -- students who may do well in school, and are close with their families. To many kids, the Choking Game seems like a harmless way to get a rush.


Parents and counselors should be on the lookout for:

  • Reports of severe headaches
  • Marks on the neck
  • Bloodshot or red eyes
  • Raspy breath; and
  • (For parents) Belts, bags, ties found around the house and closed doors or an unusual need for privacy.

Parents should also pay attention to the web sites their child may be visiting. Look out for sites that include the words "Passout," "Blackout," "Space Monkey," "Space Cowboy," "Knockout," "Gasp," or "Rising Sun." Also check web blogs or chat rooms where children may be discussing the game.


Teach students that this is not a game and that it's extremely dangerous. Kids are fascinated by the fact that they can self-induce this type of high without using drugs. They know that it's risky and dangerous -- that's part of the allure of the game -- but few know that it can be deadly. Educate parents of the warning signs to look for. Monitor school bathrooms, playgrounds, closets or closed classrooms, and other opportunities where students have to be alone together and could play the game. Understand that risk taking is a safe and natural part of growing up. Just like adults, for many kids and teens, risk taking is one way of relieving stress. Provide students with alternatives for safer risk taking. There are many activities like, skateboarding or rock climbing, which produce a safe natural endorphin or "high" for kids. The SADD Teens Today 2004 study research identified the following three broad categories of positive risk-taking. (To view the full release of the study visit


  • Social - e.g. joining a club or group
  • Emotional - e.g. asking someone on a date or sharing feelings with friends
  • Physical - e.g. rock climbing


  • Academic - e.g. taking an advanced placement course
  • Athletic - e.g. trying out for a sports team
  • Extracurricular - e.g. running for student councils


  • Volunteering - e.g. helping the elderly or homeless
  • Mentoring - e.g. working with younger children
  • Leading - e.g. starting a business or charity

The choking game is something that is not well known and is often not talked about. Kids will be secretive about it and may even pretend they don't know what you're talking about if you ask. Persevere and let them know how dangerous it is. Don't let them take their lives into their own hands.

Julie Rosenbluth, M.P.H., CHES

Marketing and Training Manager

Project Director, Transitions

American Council for Drug Education

Phone: (646) 505-2064