Q&A: Dangers of 'Choking Games'

Forget drugs, forget drinking. What some kids are doing for a quick rush is shockingly stupid and extremely dangerous. They're choking themselves for fun, and some are suffering fatal consequences.

"20/20" took a look at the foolish childhood "choking game" that has led to tragic deaths of children across the country. Dr. Thomas Andrew, a pediatrician and New Hampshire's chief medical examiner, is an expert on the dangers of this high-risk game. He advises parents to talk with their kids about the dangers of "choking games." Below he answers questions from "20/20" viewers.

Julie of Farmington Hills, Mich., asks:

What is the appropriate age to talk to your child about "the choking game?" Also, how do you bring it up if they don't even know what it is? Thank you.

Dr. Andrew:

The age range most commonly involved in this behavior is 9-14. I'm not so sure they wouldn't already know something about these games. They are more common than we adults would like to believe. I would treat discussion of this like the discussion of any other high-risk behavior like smoking, alcohol and drugs. For example, when talking about drugs, you could say, "Some kids think they can 'get high' without using drugs or alcohol by hyperventilating or putting pressure on their chest or neck. This can be just as dangerous and some kids have actually died doing it."

Jennifer H. in Thibodaux asks:

This is devastating to read. As these kids are doing this, what is taking place in their bodies to make them faint? How do they think this feels good?

Dr. Andrew:

There are two parts to the experience. The first is a light-headedness (a perceived "high") due to reduced blood flow, and therefore reduced delivery of oxygen, to the brain. The second part comes with the removal of pressure on the chest or neck releasing a powerful surge of dammed up blood up through the carotid arteries into the brain (a perceived "rush"). Who knows why anyone would think this feels good?

Sharon in Toronto asks:

I've always associated such activities with the erotic asphyxiation games played by some adults. What could the motivation be in such young children? Is it also sexual arousal?

Dr. Andrew:

This activity has no sexual component and should not be confused with autoerotic asphyxia (AEA) as practiced by older, nearly exclusively male, adolescents and young adults. Asphyxial games are played by both boys and girls, most of whom are pre-pubertal or in early puberty. The primary goal is a brief, consciousness altering experience. In AEA the sexual element is primary with pornography, cross-dressing and elaborate bindings being prominent features of the scene investigation.

Anita in Minneapolis asks:

What are the long-term/short-term side effects of this "choking game" when children do it to each other (not using leashes, belts, etc.)?

Dr. Andrew:

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