Citation

Chater AM. Addiction 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1111/add.15247

PMID

32888239

Abstract

BACKGROUND AND AIMS: Intentional asphyxiation leads to cerebral hypoxia, starving the brain of oxygen and inducing hypoxic euphoria, but carries a serious risk of accidental death, especially if practised alone. This article raises the question as to whether it could usefully be regarded as having addictive properties.

METHODS AND RESULTS: A review of the literature, together with eight case study vignettes, are presented. Intentional asphyxiation can occur with or without sexual activity. Initiation often occurs in adolescence, with development in some cases of an entrenched behaviour pattern, driven by a strong euphoriant effect, without adequate safeguarding from serious harm, and being undertaken by people with co-morbidities. There does not appear to be strong evidence of seeking support for cessation of the practice.

DISCUSSION: Intentional asphyxiation behaviours may have addictive properties and understanding this aspect of the problem may be fruitful in guiding research and interventions aimed at addressing it.

Language: en

Keywords

Hanging; Accidental death; Addiction; Autoerotic; Choking game; Hypoxic euphoria; Intentional-asphyxiation; Pleasure; Strangulation