student services

A Dangerous High

Suffocation games are dangerous, but many students see the games as an appealing way to get high without illegal drugs.

By Ralph E. Cash hree of Adam’s friends invited him to get and alone, using belts, hands, plastic bags, or high playing the “choking game.” The ropes or they may simply hold their breath or Tidea was to suffocate themselves, getting hyperventilate until they pass out. Some ado- a rush just before passing out and upon waking lescents engage in these potentially fatal games up. Adam figured that it was OK because there in response to peer pressure; others do it in were no drugs involved and it wasn’t illegal. The search of a cheap high that they think is legal. boys found a jump rope. Two boys each took an Because students may play and learn about the end of the rope and pulled slowly, and the third game in school, principals should add aware- boy caught the participant when he fainted. On ness of suffocation games to risk behavior Adam’s fourth turn, one of the boys left to go prevention efforts in their schools. to the bathroom. Instead of waiting, the others proceeded to choke Adam. He fell backward Risks of Playing the Game when he fainted and slammed his head on Loss of is never safe and always causes the corner of a bench. His friends ran for help the of brain cells. Young people who when he did not come to. Paramedics revived play suffocation games are at risk for short- him, but he had a severe , a cut that term memory loss, hemorrhage and harm required stitches, and bruising to his trachea. to the retina, from falling when unconscious, stroke, seizures, permanent brain The Choking Game damage, coma, and death (Neumann-Potash, Mounting evidence shows that many teens 2006). In addition, if the participant’s partner and even some younger children are playing accidentally squeezes a small group of nerve suffocation games. Essentially, participants cells in the neck, the participant’s can cut off the oxygen supply to the brain, induc- come to a complete stop. ing tingling or a mild, euphoric high that lasts When participants try to induce the high several seconds just before the participant loses alone, they often constrict their throats with consciousness and when he or she wakes up. ties, cords, or belts. When the flow of oxygen is The psychological effect of escaping a so-called cut off, they pass out quickly. The risk of brain near death experience also can be an induce- damage or death is increased greatly when ment for some, along with the adrenaline rush there is no one to relieve pressure, to reintro- Ralph E. Cash is an that often accompanies dangerous experiences. duce the flow of oxygen, and to restore the vic- associate professor But these suffocation games can cause perma- tim to consciousness. Many people who play at Nova Southeastern University in Ft. nent brain damage and even death (Urkin & alone are secretive about the activity, further Lauderdale–Davie, FL. Merrick, 2006). reducing the probability that help will be avail- This dangerous game goes by many names, able in time if something goes wrong. If the Student Services is such as suffocation roulette, the fainting game, activity results in death, the cause of death is produced in collaboration space monkey, blackout, the choking game, often ruled as suicide, when in fact the victims with the National Association of School the pass-out game, flatliner, funky chicken, had no intention of killing themselves. In their Psychologists (NASP). tingling, the dream game, knock-out, choke minds, they were just playing a game. Articles and related trance, ghost, airplaning, the American dream Suffocation games should not be confused handouts can be downloaded from www game, and space cowboy (Neumann-Potash, with autoerotic , a sexual practice en- .naspcenter.org/principals. 2006). Adolescents play the game in groups gaged in by some older adolescents and adults.

10 Principal Leadership november 2007 Positive Risk Taking

The Teens Today 2004 report identified three broad categories of positive risk Like the choking game, autoerotic asphyxia taking that can actually help protect adolescents from unhealthy behavior, can be fatal because participants can do it such as suffocation games and drug, inhalant, or alcohol abuse. alone and can strangle themselves acciden- tally. The choking game is generally asexual in Life Risks nature and is played primarily by preteens and n Social: joining a club or group younger adolescent boys and girls. n emotional: asking someone on a date or sharing feelings with friends n Physical: rock climbing Prevalence Statistics do not yet indicate how widespread School Risks suffocation games are, but concern about n Academic: taking an AP course the trend has grown in the medical and law n Athletic: trying out for a sports team enforcement communities in recent years. In n Cocurricular: running for student council the medical journal Injury Prevention, Le and Community Risks Macnab (2001) wrote about five cases in n volunteering: helping the elderly or the homeless which young boys strangled themselves us- n mentoring: working with younger children ing hanging cloth towel dispensers in school n Leading: starting a business or a charity restrooms. Four of the students died. Accord- ing to the organization GASP (Games Adoles- Source: Henderson, D. B., & Greenberg, G. (2004). Positive risk-taking cuts cents Shouldn’t Play), nearly 200 children and alcohol and drug use among teens. Retrieved August 5, 2007, from youths have died playing the choking game www.sadd.org/teenstoday/survey04.htm. since 2005. This does not include that were reported as suicides or serious injuries resulting from the game. A recent survey conducted by the Dylan Blake Foundation for Adolescent Behaviors (n.d.) found that 53% ing (Dylan Blake Foundation for Adolescent of boys (10–14 years old) surveyed admitted Behaviors). In fact, the activity may appeal to to playing the choking game. Of those who teenagers who generally do not break the rules had played, 86% said they played two times because it is not specifically illegal. But the a week, and 64% admitted they played alone. actual legality of one person choking another, The most frequently cited setting where they even voluntarily, is unclear, particularly if learned and played the game was school. the victim dies or suffers permanent brain Children and adolescents 10–16 years old ­damage. participate most frequently in this behavior, although older and younger youth play the Warning Signs game as well (GASP, n.d.). Indications are that Some warning signs that an adolescent may most do so out of curiosity or because they are be playing the choking game are unusual seeking a thrill, not because they are depressed marks on the neck; unexplained cuts, bruises, or angry (Dylan Blake Foundation for Ado- or hoarseness; petechiae (small red or purple lescent Behaviors, n.d.). Many adolescents spots caused by minor hemorrhaging) on the who are not outwardly at risk (e.g., struggling face or cheeks; bloodshot eyes; frequent head- in school, suffering from a mental illness, or aches; locked doors and excessive need for pri- experiencing poor family relationships), view vacy; surprising irritability, outbursts of anger, the choking game as a harmless, legal way to and other personality changes; belts and ropes get a rush. None of the documented victims with odd knots found in the teen’s bedroom or of the suffocation game were troubled youths, tied to furniture; plastic bags; questions about and many otherwise exemplary adolescents strangulation; and disorientation after spend- are drawn to the high resulting from chok- ing time alone (Neumann-Potash, 2006).

november 2007 Principal Leadership 11 student services

Good Decision Making going abroad on an exchange program, or tak- ing a job (Ponton, 1997). Helping adolescents learn to make good decisions is an important task for parents and school personnel. Suggestions for fostering good decision-making What Principals Can Do skills related to risk behaviors include: School administrators must take the lead in n Help adolescents understand the consequences of their choices. addressing and preventing student choking n Provide useful, age-appropriate information on known risks, such as the games on campus as well as in the community suffocation game and substance abuse. and at home. Specific suggestions include: n Teach students that suffocation is extremely n Help adolescents understand their own risk-taking patterns. dangerous and not a game, even if it isn’t n reinforce good decision-making and help examine the causes of bad deci- illegal. Adolescents realize and even relish sion making. Questions to ask include: the fact that it is risky, but many do not o Do your friends pressure you to make risky choices? realize just how deadly it can be. Such o Do you rush into decisions? organizations as Students Against Destruc- o Do you think it is uncool to try things in a safe manner? tive Decisions, the Dylan Blake Foundation o Are dangerous risks more exciting? Do they feel more like you? for Adolescent Behaviors, and GASP offer o Do you make dangerous choices to show off? useful information and support. o Does it feel as though the dangerous choices you make are happening in n Teach staff members and parents about a dream? the choking game. Encourage parents to n role-play decision making with students. monitor the Web sites their children visit, including blogs and chat rooms. n Keep the lines of communication open. Remain available and nonjudgmen- n Alert staff members of the game’s terminol- tal when adolescents want to talk or seek advice. ogy and slang as well as Web sites that may n remember that listening may be your most important strategy. Letting indicate or encourage participation in the adolescents work through their choices themselves, using you as a sound- choking game. Ensure that adults are able ing board, may be more effective than telling them what to do. to monitor student Internet use. Source: Ponton, L. E. (1997). The romance of risk: Why teenagers do the things n Monitor school bathrooms, locker rooms, they do. New York: Basic Books. closets, closed classrooms, and other loca- tions where students could play the game. n Reinforce the importance of parents spend- ing time with their children and staying Youth and Risk Taking involved in their lives. Research shows that Most adolescents are hard-wired to take risks. parents who take a consistent, active, nona- It is a natural part of growing up that can be busive interest in their children’s lives can safe and even beneficial within limits. Healthy exert a positive influence and reduce the risks, usually defined as challenges, help ado- likelihood that their children will engage in lescents find and define their identity. Some dangerous behaviors (Nelson, Patience, & risk taking also can be a source of stress relief. MacDonald, 1999). A 2004 study by Students Against Destructive n Provide students with alternatives for Decisions found that students who engaged in healthy risk taking, rather than attempting healthy risk taking were less likely to engage in to eliminate risk taking entirely. School is unhealthy risk taking, such as drug or alcohol an ideal environment in which students abuse or the choking game (Hendersen & can take personal, social, and academic Greenberg, 2004). Adults can help adolescents risks with appropriate support from adults channel their need to take risks into healthy ac- and peers. Taking safe, supervised, strenu- tivities at home and school, including extreme ous physical risks, such as skateboarding, physical activities, such as rock climbing; aca- running, or working out, can release natu- demic challenges, such as taking an AP course; ral endorphins that meet adolescents’ need and personal challenges, such as volunteering, to take risks.

12 Principal Leadership november 2007 Online Resources n Incorporate risk assessment strategies into References the curriculum. Provide opportunities for n Dylan Blake Foundation for Adolescent Behav- Dylan Blake Foundation students to role-play decision making. iors. (n.d.). The choking game. Retrieved August 5, for Adolescent Behavior n Establish referral procedures for students 2007, from http://thedbfoundation.com n G.A.S.P. (Games Adolescents Shouldn’t Play) www.chokinggame.net who are identified as at risk or engaged in (n.d). Save your child’s life. Be informed, be the choking game as well as other danger- aware. Retrieved August 4, 2007, from www.stop GASP and Deadly Games ous, high-risk behaviors. -the-choking-game.com/en/home.as.p Children Play n Hendersen, D. B., & Greenberg, G. (2004). www.stop-the-choking Conclusion Positive risk-taking cuts alcohol and drug use among -game.com teens. Retrieved August 5, 2007, from www.sadd Other risks, such as underage drinking, may .org/teenstoday/survey04.htm Students Against appear to be more worthy of educators’ atten- n Le, D., & Macnab, A. J. (2001). Self-strangula- Destructive Decisions tion than the choking game. But the real risk of tion by hanging from cloth towel dispensers in (SADD) the choking game is greater than it appears. Its Canadian schools. Injury Prevention, 7, 231–233. www.sadd.org seemingly innocuous and legal nature is part n Nelson, B. V., Patience, T. H., & MacDonald, of its allure. Schools can use comprehensive D. C. (1999). Adolescent risk behavior and the DARE influence of parents and education. Journal of the risk prevention programs that are already in American Board of Family Practice, 12(6), 436–443. www.dare.com place to educate students about the choking n Neumann-Potash, L. (2006, Fall). The choking Connect with Kids game and teach them risk assessment and game. California Pediatrician, 22. www.connectwithkids.com positive decision-making skills. In the end, n Ponton, L. E. (1997). The romance of risk: Why for some students it is not really a game; it is a teenagers do the things they do. New York: Basic Books. n Urkin, J., & Merrick, J. (2006). The choking matter of life and death. PL game or suffocation roulette in adolescence. International Journal of Adolescent Medical Health, 18, 207–208.

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