Study reveals hike in choking for pleasure


The use of strangulation to get a high has led to many youth deaths, and that number has increased in the last decade, according to a recent study.

According to a Feb. 15 Morbidity and Morality Weekly Report by the Centers for Disease Control and Prevention, 82 “choking-game” deaths have occurred since 1995.

The deaths ranged in children and adolescents ages 6 to 19, but the mean age of the deaths was 13, with 71 percent being male.

The report defined the choking game as “a self-strangulation or strangulation by another person with the hands or a noose to achieve a brief euphoric state caused by cerebral hypoxia.”

Debra Bolton, K-State extension agent with the Kansas Family Partnership, said the strangulation behavior used to get a high is a symptom of disengaged youth, or youth who don’t feel like they have an important job to do in supporting their families or communicating effectively with them.

Bolton said she thought youth learn about the behavior from the media and from word of mouth. She mentioned a specific movie, “Life as a House,” where there is a scene of a youth shown huffing and hanging himself to get a high.

“If a young person is watching those kinds of things, they’re witnessing all kinds of violence,” she said.

Bolton said the behavior is typical for the stages when youth reach puberty and more so after that time.

She said she has heard of these incidents in Kansas but not of any in the last 12 months, though she said that does not mean that any have not occurred.

According to the CDC Web site, someone can die from strangulation, which in these cases is not intended for suicide, “within three minutes of continued strangulation” when the basic functions and the central nervous system fail.

The site reports other consequences, including death of brain cells, coma, seizures and hemorrhages of the eye.

The CDC report noted the study was the “first attempt to assess the national incidence of deaths among youths resulting from the choking game.” Though this behavior might have been practiced years before, “the use of a ligature while playing appears to be a new practice that can be fatal.”

The report showed that the deaths have increased since 1995, where from that year until 2004, about three deaths were recorded. However, in 2005 there were 22, 35 in 2006 and nine in 2007.

According to the MMWR report, there is no public health dataset that tracks deaths because of accidental strangulation used to get a high. The 82-death number found from the CDC study was calculated from media reports since the 1970s.

Elaine Johannes, K-State extension youth development specialist, said research and behavior tracking is done through a surveillance system, which has not yet been created for intentional strangulation.

She said the surveillance would likely have to be created from an effort by the federal government to have doctors screen for the behavior, but that is difficult.

“It is a complex issue that is not easily solved,” she said.

When there are cases of children strangling themselves or having friends do it, it can be difficult to know if the child is doing it to get a high or if it is a suicide attempt, Johannes said.

Johannes said she does not think the behavior is as prevalent as other risky behaviors in youth, though she said that could change with more attention by the media. She said it is dangerous to refer to the behavior as a “game,” because the behavior could increase.

“I am not a big fan of taking bizarre behavior and sensationalizing that,” she said. “As adults, we need to be thoughtful in our information around kids.”

Johannes said the more the behavior is labeled as a game, the more it is attractive to youth who engage in risky behavior. She used examples of the game “chicken” and said children cannot always distinguish a game from harmful behavior.

Johannes said the behavior is rare, and she thinks, if the cases would increase, it would not become a trend like bingeing. She said self choking is related to other risky behaviors, and families should be aware of these.

Bolton said an important part of prevention is to include the whole family in the prevention practice to promote health and behavior.

“Health is physical, mental and emotional well-being,” she said. “All of those things promote a youth who is doing well in school and actively engaged in activities with peers.”