ATLANTA - At least 82 youths have died from what some have called the "choking game," according to the first government count of fatalities from the tragic fad.
The choking game involves intentionally trying to choke oneself or another in an effort to obtain a brief euphoric state or "high."
As many as 20 percent of teens and preteens try the choking game, sometimes in groups, according to estimates based on a few local studies. Nearly all the deaths were youths who had been alone, according to the count compiled by the US Centers for Disease Control and Prevention.
The CDC started the research after receiving a letter last year from a Tacoma, Wash., physician who said her 13-year-old son died from the activity in 2005.
"At the time I had never heard of this," said Dr. Patricia Russell, whose son was found hanging in his closet. She later learned he had talked to a friend about it.
"One thing that really needs to happen - and is starting to happen now - is to get more information about how common this is," she said.
The CDC counted cases from news reports and advocacy organizations in the years 1995 through 2007, totaling 82 fatalities of children ages 6 to 19. They did not include cases in which it was unclear whether the death was from the choking game or whether it was a suicide. They also did not include deaths that involved autoerotic asphyxiation, which is self-strangulation during masturbation.
The 82 deaths were spread across 31 states. Nearly 90 percent were boys, at an average age of about 13, the CDC found.
The report is being published this week in a CDC publication, Morbidity and Mortality Weekly Report.
CDC officials urged parents to be aware of the fad and to watch for possible warning signs such as marks on the neck, disorientation after spending time alone, and ropes, scarves, or belts tied to bedroom furniture or doorknobs or found knotted on the floor.
The authors acknowledged that 82 is probably an undercount. They could not rely on death certificates, which do not differentiate choking-game deaths from other unintentional strangulations. Instead, they relied mainly on a database that is large but doesn't include all media outlets.
It's likely that about 100 die each year from the fad in the country, said Dr. Tom Andrew, New Hampshire's chief medical examiner, who has been studying the phenomenon for several years.
The activity is also known by names that include "blackout," "space monkey," and "pass out."