The choking game “is much more common than most people realize,” said Dr. James Jarvis, administrator of the Center for Family Medicine at Eastern Maine Medical Center in Bangor. Yet many doctors, including family practitioners and pediatric specialists, don’t know about the dangerous behavior and fail to screen young patients or counsel parents about it.

Signs that a youngster may be practicing the choking game include:

— Bloodshot eyes.

— Red marks or bruises on the neck.

— Wearing high-necked shirts to hide bruising.

— Frequent headaches.

— Spending time alone in a locked bedroom.

— Disorientation, irritability and hostility.

— Finding objects such as belts, ropes, scarves, neckties, dog leashes or bungee cords tied to a bedpost, doorknob or closet bar.

Citing public health data from the U.S. Centers for Disease Control and Prevention, Jarvis said Friday that juveniles of both genders ages 11 to 16 are the most likely to take part in the choking game. Boys in eighth grade are the highest-risk group, he said. Males are more likely than females to practice the choking game alone — and are more likely to be seriously injured or die in the process.

While youngsters with mental health problems or a habit of substance abuse are slightly more likely to engage in the dangerous activity, all youngsters are at risk, he said.

Jarvis drew a distinction between the choking game used by adolescents to get high and the sexually charged autoerotic asphyxiation practiced by some adults.

Youngsters, he said, “are just trying to get high. Some children have said they do this because they know drugs are bad.” Clearly, he said, the choking game poses a serious danger of its own and must be discouraged by health care providers, parents, teachers and other adults.

Jarvis said there is little doubt that a significant number of teen deaths reported as suicide are instead accidental deaths caused by the choking game.

Meg Haskell

Meg Haskell is a curious second-career journalist with two grown sons, a background in health care and a penchant for new experiences. She lives in Stockton Springs. Email her at