Roughly 821* children have died playing some form of the Choking Game, according to Games Adolescents Shouldn’t Play (G.A.S.P.), a non-profit association that strives to educate youth about the hazards pertaining to the Choking Game and ultimately put a stop to it.

It’s Anything But a Game

Popular among 9 to 16-year-olds, the Choking Game is an extremely dangerous activity in which kids purposefully choke themselves, or each other, to obtain a brief sensation of euphoria. Nicknamed the “Good Kid’s High” because it is often viewed as a safe, legal alternative to drugs, the Choking Game has many variations in its execution, and is known by multiple names including: Pass Out, Choke Out, Roulette, Tingling, Suffocation, Blackout, Flatliner, Fainting Game, Rising Sun, American Dream, California High, Space Monkey, Airplaning, Funky Chicken and Space Cowboy.

Participants “play the game” by using their hands, belts, scarves, rope, or other similar items that can function as a makeshift noose to cut off blood flow to their own, or a friend’s, brain by applying pressure to the neck. They maintain this pressure until they either pass out, or simply can no longer tolerate it. Once the pressure on the neck is released, all the blood that was blocked rushes to the brain. Because 20% of the oxygen taken in by the body is required by the brain to function normally, the brain is essentially being suffocated when it is deprived of blood flow. The high that is experienced (a light-headed, warm fuzzy feeling) is the chemical reaction of brain cells dying.

The Consequences

The Choking Game can result in permanent brain damage (the brain cells that are killed cannot be regenerated), a vegetative state, and death. Because participants often pass out, falling creates an added danger. Death, broken bones, concussions, major cuts, and eye injuries have all been reported as a result of falling during the Choking Game.

The following statistics, from a study by the Centers for Disease Control and Prevention (CDC) expound on who is most at risk.

Of the cases in the study, boys were more likely to die from the choking game than girls.

Most of the children (89%) that died were 11-16 years old.

Nearly all of the children who died were playing the game alone when they died.

Deaths have occurred all over the United States; the Choking Game isn’t limited to one area of the country.

Warning Signs

Don’t make the mistake of assuming your child doesn’t know about the Choking Game. As with other dares we have written about, YouTube hosts a plethora of videos that feature teenagers performing the Choking Game on each other while laughing hysterically. There’s a good chance your child has seen one. As a parent, knowledge and education are the best defense you can have. Talk to your kid about the dangers of this dare, and keep an eye on them for these warning signs:

Bloodshot eyes.

Complaint of frequent headaches.

Marks on the neck.

The inexplicable presence of dog leashes, bungee cords, choke collars, and ropes, scarves, or belts found knotted in their room, bathroom, or basement.

If you become suspicious that your child may be experimenting with the Choking Game, do not hesitate to confront them about it. It could mean their life.

*Because deaths as a result of the Choking Game are often mistakenly reported as suicides, accurate statistical measurements are problematic. The Centers for Disease Control and Prevention claim that at least 82 children died from 1995 to 2007 as a result of playing the game. Some experts estimate that there may be as many as 1,000 deaths per year.