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The Real Story About The ‘Pass Out Challenge’

A not so new fad has made its way into the public eye; the “Pass out Challenge” has been around since 1995 but recently has surfaced as a real issue in today’s teen and preteen social circles. This game has several different forms, all promising the participant a euphoric high. This “Good Kid’s” high is much like the mood altering experience of smoking weed or taking other illicit drugs without the side effect of not being able to pass a drug test the next day. The best way to protect children from this potentially deadly game is to know a few things.

What Is the Pass Out Challenge?

First, what is the pass out challenge? If a parent knows what the game is about and when and where teens are being “challenged,” they can then talk to their teens about it. Second, what are the signs that a teen has been playing this game/challenge; knowing the signs that a teen has been playing will help in starting the conversation between a parent and their teen. Knowing the signs also make it easier on the parent to confirm what they suspect may be going on behind the closed doors of a teen’s life. Third, why do these teens play this game? What are the reasons for playing? Knowing the answers here can help parents understand the motivation behind this deadly challenge and make the conversation less tense and emotional.

Finally, and most importantly, what are the long term effects of the “Pass out Challenge?” What is happening to the teens playing this game? Is it really a victimless game? What are the long-term effects to the brain or the body of a person who plays? The answers to those questions will help a parent talk to and inform their teens about what is going on in their bodies to induce the euphoric feelings they are seeking for and what the side effects could be in the long run.

How to Do the Pass Out challenge?

The “Pass out Challenge” is a not so new fad in the social life of American teens. There are several different ways to play the game; however it seems the most popular pass out challenge instructions are;

– The player squats down as close to the ground as possible

– The player then takes rapid deep breaths for about 45 seconds

– The player stands up rapidly and then sits down

– While sitting the player places his/her thumb in their mouth and blows on it until they pass out. (azombiesgirl, 2013)

Another set of pass out challenge directions for this pass out game involves two people. One person will apply pressure to the other person’s chest until they pass out (Forest, 2014). This is done by placing a knee on the chest, sitting on the chest, even standing on the chest of the person playing the game.

Enough pressure to compress the lungs and not allow them to inflate again must be applied. Doctors are concerned about this form of the game being found by teens and pre-teens on very popular social media sites. Their concern stems from the amount of pressure needed to achieve a “high” which also changes the participants’ heart rate and can cause serious damage to the ribcage and lungs (Forest, 2014).

The final “popular” version of this game involves strangulation. Strangulation is achieved by either manual or ligature forms. In this version of the challenge the participants will choke themselves until they are almost at the point of passing out and then are to loosen the hold or ties producing a “high” from the lack of oxygen to the brain (Weiner, 2012).

This is not only the most popular form of the challenge, but it is also the most dangerous. Children and teens participating in this form of the game believe they have more control than they really do. They believe they will always be able to control the pressure and release of that pressure every time they play it. This misconception is what makes this the most dangerous version of the game.

Children and teens are unaware of how quickly they can pass out and that the more they play the game the longer they will have to be strangled to achieve the desired high. In a study done by the Oregon Health Authority in conjuncture with the CDC (Centers for Disease Control) in 2012 it was found that the pass out challenge death count between 1995 and 2007 is approximate 82 children between the ages of 6 – 19 years old (Weiner, 2012).

The Signs Your Child Is Playing the Choking Game

There are several general signs that a child or teen has been taking part in the “Pass out Challenge” or the “Choking Game.”


Unexplained Bruising around the Neck or Other Body Parts

The participant in either “game” will have bruising that they are either embarrassed about or cannot or will not explain. These bruises can be from falling down as they pass out and hitting objects or from strangulation. If they are from falling down they will be located around the chest, head, legs, and arms and can be easily passed off as normal wear and tear on their bodies. Bruising from strangulation will be around the neck and there will not be a reasonable explanation for the bruising. Teens participating in this game will want to cover their necks as much as they can so they will not have to explain the bruising.


The headaches will be sever and will continue for a few days after the event. They will be located in the frontal lobe of the brain and will affect vision and reason.

Bloodshot Eyes

The participant will have bloodshot eyes and look “stoned” for a time right after the event. They will appear tired and mellow.


The participant will seem to not be aware of the world around them in the same context as others. They may be confused as to where they are or who they are with. Participants may have problems with spatial orientation for a time directly following the event.

All of these are signs that a person has been participating in the “Pass out Challenge” or the “Choking Game” (Weiner, 2012).

Why Do Children and Teens Play This Game?

The reasons children and teens play these games and take these challenges vary. In a popular crime drama TV show it was about peer pressure and wanting to make their school the best (Spera, 2010). It can be about popularity and a sense of keeping up with the others in their group. It can be a dare, or a silly way to let off steam. No matter what reason, children and teens need to know how dangerous any version of these challenges can be.

One disturbing reason found for some children and teens to play this game is the thought that it is a legal way to “get high” without all the side effects of illegal drugs. This form of “high” is popular among athletes, and other groups who are regularly drug tested. These participants are regular “users” of the game/challenge (refer to the signs of participation above) and will have noticeable marks but will not test positive in their drug screenings. Participants believe this to be a safe and a better alternative to illegal drugs because of this and what they believe to be no actual damage to their bodies.

Other children and teens use the “passing out game” as an outlet for emotional distress. It may have started out as a dare, or a way to fit in with others but they find that it provides an escape from their reality as well. These children or teens use the “high” as a means of dealing with stress and emotional problems either from home or social groups. Parents should contact professional help for their child or teen if they believe there is an emotional issue that needs to be addressed.

Long Term Effects of the “Passing Out Game”

While participating in the game children and teens are generally unaware of the effects it is having on their brains. Oxygen deprivation to the brain is called Hypoxic-Anoxic Brain Injury. This occurs when the oxygen is either completely or partially cut off from the brain. The disruption of blood flow to the brain is what causes the “high” children and teens are looking for when participating in this challenge or game.

HAI (Hypoxic-Anoxic Injury) has a lasting effect not just on the victim but also on the friends and family of the victim. These persons generally need long term, costly and substantial medical and rehabilitative services for recovery. Patients suffering from a HAI may also suffer from long-term disabilities both mentally and physically.

So what causes the “high” children and teens look for with the “Pass out Game”? The high is caused by the disruption of the neurotransmitters involved in mood control. Specifically serotonin, dopamine and norepinephrine; these three neurotransmitters are directly responsible for mood control. When the oxygen flow to the brain is disrupted causing the participant to pass out, these neurotransmitters attempt to compensate for the disruption, creating a “high” or euphoric feeling.

The long term effects can vary from just passing out and having the high to cell death in the brain or even death of the participant. Cell death can occur within minutes of the deprivation of oxygen. Depending on the location of cell death and the amount of cell death motor function impairment, visual impairment, speech impairment, and sometimes higher brain functions can result. Loss of motor function can be deadly while playing these games. When motor function becomes impaired the participant can no longer loosen the hold in the choking game almost always resulting in pass out challenge deaths by strangulation. Also this impairment may cause serious injury to a participant in the pass out game due to the inability to use their arms and legs to catch them as they fall. This may result in superficial and/or serious head, face and limb injuries.

Talking to Children about the Pass Out Game

It is increasingly important with social media, social networking, and the frequent use of the Internet by children and teens to discuss the dangers of this challenge with children and teens. It is important to remember while discussing this topic that these potential participants are not aware, or don’t want to be aware, of the dangers of the game and therefore need to be educated. Yelling, overreacting or “preaching” may not be the best approach to the conversation. These approaches will only bring tension and a lack of communication. Before parents talk with their children, about this or other dangerous games, they should become educated themselves and be calm and rational about the information they find.
Parents should use reliable and professional sources when possible to understand all the reasons children and teens play the game and participate in this dangerous challenge. These resources will be the best source of factual information and are generally written with an emphasis on all consequences good and bad on the subject.

Parents should choose a time where stress is not high in either their lives or their children or teens’ lives to discuss this challenge. Accusations and anger should be overshadowed, if not eliminated, by concern and caring for the child and a desire to really inform. This may be hard for parents to accomplish alone, please seek out professional help from doctors and other health care providers if needed.

For Further Information on the Pass Out Game/Choking Game:

For more information about these games/challenges please see the following articles and resources:

“Doctors warn parents and children about the dangers of the pass out game,”  posted October 4, 2014, by Ashley Forest

“The ‘Choking Game’ and Other Dangerous Games Your Kids Should Avoid,” posted April 16, 2014 by Miriam Weiner Keywords: Pass out Game, Choking Game, Pass out Challenge

“Hypoxic-Anoxic Brain Injury,” Family Caregiver Alliance posted December 31, 2004

Criminal Minds “Risky Business” season 5, episode 13, air date of 2010 directed by Rob Spera

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  • Joe Simpson
    Jan 19, 2015 at 03:08 am

    Extremely old news. We did this (hyperventilating, not strangling or pressing on other’s chests) back in 1975. instead of blowing against the thumb, it was against the little fingers stuck in the corners of the mouth.
    So, young folks who think this is a cutting edge fad… keep in mind that this is something your parents and GRANDPARENTS probably did. Find something else to make yourself feel like you’re a rebel. LOL.

  • Joey Scagnoli
    May 13, 2015 at 03:52 am

    it predates 1995, and is nothing like marijuana. it is a horrible thing to do-the fainting game. I know first-hand. But please do not make a habit of not being factual in your intro to a story

  • Joey Scagnoli
    May 24, 2015 at 01:50 am

    it predates 1995, and is nothing like marijuana. it is a horrible thing to do-the fainting game. I know first-hand. But please do not make a habit of not being factual in your intro to a story

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