By Natasha Persaud

It’s enough to make you gasp. Just when you thought you knew about all the threats facing your tweens and teens—alcohol, drugs, cutting—comes word of another danger with instantly deadly consequences: intentional strangulation.

Choking Game Image - Masterfile

It’s called the choking game: Using a belt, towel, rope, leash, another item or bare hands around the neck, a child applies pressure to the carotid artery to cut off blood and oxygen supply to the brain. Once the pressure is released, a "high" or euphoric feeling might be achieved as blood and oxygen rush back to the brain.

Of course, parents know that this isn’t a game at all. Strangulation can quickly lead to fainting, injury, brain damage, and death. But many young people don’t understand the seriousness.

According to a Pediatrics study of Oregon teens, as many as 6 percent of eighth graders (and perhaps as many 11th graders) may be playing the "game." A majority—64 percent—of these eighth graders have engaged in the activity more than once and more than a quarter (27 percent) have cut off their air supply more than 5 times. Males and females participate in the game in equal numbers, sometimes in groups or, more often, alone.

Teens who abuse alcohol or drugs or engage in sexual activity may be particularly at risk, according to the study. Gambling, violence, and poor nutrition may also play a role, but even students with no known risk factors can become victims.

While it’s tempting to believe that your child has never heard of the choking game, about a quarter of the 5,000 teens in the Oregon study knew about it. And, according to The Dangerous Behaviors Foundation, up to 75 percent of middle schoolers have probably heard of it.

The choking game has many alternate or slang names, including:

  • 5 minutes of Heaven or 7 Minutes 'til Heaven
  • Accupuncture Game
  • Airplaning
  • America Dream(ing) or Something Dream(ing)
  • Black out or Black Hole
  • California High
  • Choke Out
  • Cloud Nine (9)
  • Dream (Game)
  • Elevator (Game)
  • Fainting Game
  • Flatline Game
  • Flat liner (Game)
  • Funky Chicken
  • Gasp(ing) (Game)
  • Good Kids Game
  • Hang(ing) (Man) Game
  • Harvey Wall Banger
  • High Riser (Game)
  • Huff(ing) (Game)
  • Hyperventilating
  • Knock-Out (Game)
  • Lions and Tigers
  • Pass(ing) Out (Game)
  • Purple Dragon
  • Rising Sun
  • Rush
  • Sleeping Game or Sleeper Hold
  • Snuff (Game)
  • Space Cowboy
  • Space Monkey
  • Speed Dreaming
  • Suffocation (Game)
  • Tap Out
  • Teen Choking Game
  • Tingling Game
  • Twitching Game

Parents, Talk About The Choking Game

A simple question parents might ask their children is, “What do you know about the choking (pass out) game?" The Dangerous Behaviors Foundation also suggests taking these steps:

  • Be aware of the warning signs:
    • >Frequent, often severe, headaches
      • Bruising or red mark on the neck
      • Bloodshot eyes or petechiae (tiny red dots) on the face
      • Locked or blocked bedroom or bathroom doors and unusual demands for privacy
    • Increase supervision: Be aware of your child's activities and whereabouts and make an "open door" rule for the bedroom. Your child's safety is more valuable than his or her privacy.
    • Remove any items that could be used as a noose, such as belts, scarves, cords, even closet rods if you must.


    The Dangerous Behaviors Foundation, available at

    Ramowski, et al. “Health Risks of Oregon Eighth-Grade Participants in the “Choking Game.” Pediatrics 2012;129;846. Originally published online April 16, 2012. DOI: 10.1542/peds.2011-2482

    Publication Review By: the Editorial Staff at

    Published: 02 May 2012

    Last Modified: 28 Aug 2015