It’s not a game at all—just an act of suffocating on purpose.

Adolescents cut off the flow of blood to the brain, in exchange for a few seconds of feeling lightheaded. Some strangle themselves with a belt, a rope or their bare hands; others push on their chest or hyperventilate.

When they release the pressure, blood that was blocked up floods the brain all at once. This sets off a warm and fuzzy feeling, which is just the brain dying, thousands of cells at a time.

Mostly boys and girls between 9-16 years old, nationwide and around the world. These adolescents are generally high-achieving in academics, activities and sports, and don’t want to risk getting caught with drugs or alcohol. The practice is taught through word of mouth and through the internet.

By one name or another, the Choking Game has been going on for well over 20 years. But the most recent use of bonds (ropes, belts) and the growing practice of playing alone have increased its deadliness dramatically.

It’s estimated as many as 250 to 1,000 young people die in the United States each year playing some variant of the Choking Game, but it’s difficult to track statistics because many of the cases are reported as suicides.

Some do it for the high, which can become addictive. Others do it because it's “cool” and risky. Most kids who have died from this were active, intelligent, stable children who thought this was a safe alternative to drugs and alcohol. Most children have no concept of their own mortality—they truly believe nothing can hurt them.

The plan is to release pressure at just the right time before passing out. If they pass out first, the weight of their body pulls on the ropes and they can die. There’s also the chance of seizures, stroke, or injuries from a fall.

Playing the game in any form causes the permanent death of a large number of brain cells. Within 3 minutes without oxygen to the brain, a person will suffer noticeable brain damage. Between 4 and 5 minutes, a person will die. Some of those kids who died were alone for as little as 15 minutes before someone found them, and it was already too late.

Also, the rush they’re getting can be addictive. Many times the Choking Game starts off as a social activity, but adolescents end up doing it alone, which is even more dangerous—nobody’s around to help them if they pass out.

Talk to the children in your life, as well as parents and everyone you know who works with children. Make sure they understand why the Choking Game is so dangerous: even if they survive, they’re permanently killing thousands of brain cells, and other children may be indicted and prosecuted for their involvement in a death or injury.

• Any suspicious mark on the side of the neck, sometimes hidden by a turtleneck, scarf or permanently turned-up collar.
• Changes in personality, such as overtly aggressive or agitated.
• Any kind of strap, rope or belt lying around near the child for no clear reason—and attempts to elude questions about such objects.
• Headaches (sometimes excruciatingly bad ones), loss of concentration, flushed face.
• Bloodshot eyes or any other noticeable signs of eye stress.
• A thud in the bedroom or against a wall—meaning a fall in cases of solitary practice.
• Any questions about the effects, sensations or dangers of strangulation.

Blackout, Fainting Game, Space Monkey, Dream Game, Suffocation, Roulette, Passout, Flatliner, California High, Airplaning, Space Monkey, American Dream, Funky Chicken, Tingling, Gasp.

Be proactive and warn them about this activity—they often don't know it can kill them or leave them brain damaged. Supervise him or her very closely, and check that siblings are not involved. Dispose of items that could be used for this purpose. Alert school officials so they can monitor the situation; often other students may also be participating. Consider alerting the adolescent’s friends’ parents as well. If you feel strongly that your child may be doing this, seek professional counseling and support for your child and your family.