But kids are smart and are finding new ways to get high from a practice of which their parents might not yet be aware. Looking for drugs in their dresser drawers and closets and smelling their breath or clothing will not likely help to find this newer practice. The Choking Game, also known as Pass Out, the Fainting Game, and Space Monkey, is when a person cuts off the supply of blood and oxygen to the brain to induce a high sensation.

According to a Texas university study, 1 in 7 college students have played the Choking Game in order to get high. Unfortunately, those who play this game sometimes accidentally kill themselves or their friends.

Easy to Play, Easy to Lose

It’s easy to play the Choking Game, but the losses are tragic. There are no monetary costs for drugs, no illegal purchases. Game "pieces" include simple things like rope, string, ties, or plastic bags.

A person can play the game alone or with others. Players tie ropes, neck ties, or whatever they can around their neck and tighten it until the person loses consciousness. Other players place plastic bags over their heads to cut off their supply of oxygen.

Researchers from Sam Houston State University’s Crime Victims’ Institute conducted a survey on the practice of "Choking." Out of 837 students, they found these statistics:

• First-time players’ average age was 14
• More males played it than females
• 16 percent had played the game at least once, three-fourths twice or more
• Most students began playing it in a group

It’s Not Suicide

Children and young adults who play these games are often unaware of the tragic dangers of this game. At an age where they sometimes feel invincible to death, these kids are shocked when a friend or sibling dies from accidental strangulation.

Child psychologist, Dr. Lawrence Shapiro, believes that some of these fatalities may have previously been misidentified as suicides. Because children use ropes, ties, and other objects to strangle themselves into unconsciousness, it looks as though they were attempting to take their own lives.

Prevention

Awareness of this problem is key in helping parents and teachers educate youth about the dangers of this game. A survey revealed that 90 percent of parents believe that school health classes should educate students about the dangers of this game.

Parents can watch for these warning signs in their child:

• Bruises or marks on child’s neck
• Frequent headaches
• Bloodshot eyes
• Collecting ropes or plastic bags

One mother whose child died from choking has started her own website for prevention. She noticed that there were hardly any Internet sites that talk about this dangerous game. She hopes her website will help educate parents about choking and help them identify warning signs so they can prevent any tragedies in their own family.

So who is your teen friends with – and why does it matter? Whereas a positive peer group can influence your teen to excel in school, join a sports team or pick up a hobby, a negative peer group can take your teen on a fast downward spiral. Here are a few signs your teen’s friends may be putting them at risk.

Having Too Many Friends

When it comes to the size of your teen’s social network, less may be more. According to researchers from the University of Wisconsin, Madison School of Medicine and Public Health, adolescents with lots of friends are more likely to start drinking alcohol (even if those friends don’t drink) than teens who have just a few close friends.

The same study suggests that being “in” with the in-crowd is overrated. The researchers found that the more popular people in a teen’s social network, the greater the risk that the teen would start drinking.

Researchers believe too much time spent maintaining a social network means less time bonding with family. Future research may help determine whether the same results hold true with social networking websites like Facebook.

Having Older Friends

Having older friends can increase the chances that your teen will get involved in substance abuse, unprotected sex and other risky behaviors. The size of the age gap – for example, one or two years versus three or four years – makes a difference, as does the age of your child and trustworthiness of the friend. A 17-year-old hanging out with a well-adjusted 18-year-old may not be cause for concern, but a 13-year-old buddying up with a 16-year-old rebel may be a red flag.

Having Friends of the Opposite Gender

Studies indicate that during early adolescence boys can be friends with girls, but girls can’t be friends with boys. Research published in the Journal of Research on Adolescence suggests that girls who make friends with boys in early adolescence are more likely to develop substance abuse problems than those who hold off on co-ed friendships. Boys, on the other hand, can become friends with girls in early adolescence without facing these risks.
The same study also showed that girls with male friends were more likely to struggle with antisocial behavior and early puberty. They were also more likely to be friends with older males, which further increases the risk of substance abuse and risky sexual behavior. As boys and girls mature, and co-ed relationships become the norm, these risks lessen.

Having Friends Who Misbehave

The number, age and gender of your teen’s friends may be less significant than whether or not they are positive influences. A study published in the Journal of Early Adolescence shows that teens whose friends were prone to misbehave performed worse in school than those whose friends are socially engaged in positive ways, such as completing assignments on time or joining a team sport at school.

Alcohol-Abusing Friends of a Love Interest

It’s not only your teen’s friends that have an influence on their behavior. The friends of your teen’s boyfriend or girlfriend can also impact your teen’s decision to drink alcohol or not, according to research published in the journal American Sociological Review.

If a love interest’s friends drink alcohol heavily or frequently, your teen is more likely to follow suit, even if their own friends and romantic partner do not drink. In fact, if friends of friends are heavy drinkers, your teen is more than twice as likely to binge drink as teenagers with friends or romantic partners who are heavy drinkers, the researchers said.

The good news is that the effect works the opposite way as well. If a love interest’s friends do not drink, your teen is less likely to abuse alcohol. Teens may believe that behaving more like their date’s friends will strengthen their relationship.

Parents Reign Supreme

Teenagers are in the process of figuring out who they want to be. They need some latitude to explore new friendships, but that doesn’t mean you’ll be forced to sit on the sidelines. Your teen’s friends matter, but you matter more. Stay involved in your teen’s life, get to know their friends and be sure to make family a priority. As important as friends are, research shows that teens benefit most when time with the family comes first.

Plummeting Self-Esteem

Girls’ self-esteem peaks around age 9, and then drops off dramatically, according to studies from New York University’s Child Study Center. Why? Experts speculate that the following factors are at play:

• Hormonal shifts related to puberty, which often result in weight gain and other physical changes
• Media messages that convey unrealistic physical standards and sexualize young girls
• Peer pressure and an increase in bullying

Low self-esteem at this critical age can spell bigger problems later on. Girls with low self-esteem are more likely to struggle with eating disorders, cutting, alcohol and drug abuse, and unsafe sex. And the younger they get involved with these risky behaviors, the more serious the problems are likely to get during adolescence.

Changing Beliefs About Drug and Alcohol Abuse

The age of 9 is also a critical milestone for drug and alcohol abuse. Attitudes toward drugs and alcohol are established long before a child takes their first drink or experiments with a drug. Before age 9, studies show that children view drug use as bad choice with negative consequences. But shortly thereafter, by age 13, children’s attitudes toward drugs and alcohol are more positive.

Start the Conversation Today

It may seem like just yesterday that your child was learning to walk and talk. How could it already be time to talk about such weighty issues as drugs and sex? But waiting can have serious consequences for your child and your family.

At 9 years old, children still look to their parents to guide their behavior. Research shows that young people are less likely to experiment with drugs and alcohol and start having sex when their parents are loving, supportive and actively involved in their lives.

For this reason, experts strongly recommend that parents talk openly and often with their 8-, 9- and 10-year-olds about the dangers of drugs, sex and other behaviors. Set clear rules and expectations, offer plenty of praise and encouragement, and open the lines of communication now while your child is still listening.

Even more alarming, says Elyse Singer in a West Hartford News article, is that teens seem to believe that binge drinking episodes are normal, expected and harmless. Singer is part of the Community Action Research Team project, West Hartford, Conn., a yearlong initiative to study teen trends around alcohol.

Others involved in the project say it’s difficult to pinpoint where or how teens are getting the message that binge drinking is normal or harmless, but believe it’s linked to media messages, online videos and advertising of products that promote a fast intoxication. Consequences from binge drinking can include a higher chance for alcohol addiction, dangerous driving decisions or unprotected sex, as well as organ damage to the liver and kidneys. Alcohol poisoning is also increasing and sending more teens to emergency rooms nationwide.

Teens and young adults interviewed in the Community Action Research Team project said they drink to boost self-esteem; to escalate their levels of enjoyment when spending time with friends; and to manage life stressors or negative emotions. As competition for high school grades, scholarships and athletic recognition mounts, more students may be turning to alcohol to escape, say the researchers.

Binge drinking seemed to be participated in by more Caucasian students than from other groups in the West Hartford study, and they were typically in the middle to upper social classes. The trend, say researchers, is similar across other U.S. communities.

Most of the teens in the study who were binge drinking were consuming hard alcohol they acquired from their homes. Singer and fellow researchers are urging parents to set clear expectations for their teen and to help them find activities that don’t involve alcohol.

According to a recent study, teens are five times more likely to be involved in a car accident when driving with a group as compared to driving alone. Teens are also more likely to commit a crime when among friends. To better understand why, Temple University psychologists Jason Chein and Laurence Steinberg studied brain activity in teens when risk was involved.

This study was featured in a recent Science Daily release and its findings suggest that when teens are with their friends, they are more susceptible to the potential rewards of a risk than they are when they are alone.

Researchers looked at preventable, risky behaviors such as cigarette smoking, careless driving and binge drinking to understand why teens might engage in such activities. In studying brain activity, researchers determined that teens would take more risks when they knew their friends were watching.

Chein noted that the more significant finding was that the regions of the brain associated with reward showed greater activation when adolescents knew their peers were observing their actions. This suggests that the presence of peers heightens the sensitivity in the brain to the potential upside of a risky decision.

Teens appear to find socializing so rewarding that being with friends will actually prime the reward system and make teens pay more attention to the potential payoff of a risky decision. This finding suggests that parents should pay much more attention to those people their teen selects for socialization.

While teenagers spend more time with their peers than they do their parents, to what extent can parents have a place in impacting their child’s decisions about substance abuse? A recent study looks at the protective factors parents can provide for their children.

Piko and Kovacs recently examined the possible protective factors involved in an adolescent’s choices, as well as the combined role of parental protection and school-related protection.

The study focused on adolescents in Hungary, with 881 participants from give randomly-chosen high schools in Szeged. The students were all between the ages of 14 and 20 years old.

The questionnaires were administered after a brief explanation of study objectives and were completed voluntarily and confidentially by the students. The questionnaires sought to establish the level of involvement the students had with smoking, binge drinking and marijuana.

The questionnaires were also used to evaluate the relationship each student enjoyed with their parents and their satisfaction and involvement at school. Questions were asked to assess the level of satisfaction in the parent/child relationship, establishing the closeness and influence each parent had on the participant.

The questions about parents related to such areas as how appreciated the child felt by his or her parents, whether the student often talked with his or her parents about personal problems, and how often the students ate dinner with parents. School questions examined areas such as academic success, satisfaction with the school and relationships with teachers.

The results of the study show that, despite the increasing importance of peers in the lives of adolescents, the role of the parents is still an important protection against substance use in certain parental variables. For example, parental monitoring may prevent risky situations where substance use may occur, and having dinner with the family was a predictor of lower substance use.

High academic achievement was found to be the most important predictor for school-related protection from substance use. Satisfaction with the school and personal relationships with teachers also impacted the protection for adolescents, indicating that drug use is more influenced by emotional factors than rational.

The study’s limitations include the specific cultural context of the study, the cross-sectional study design and the use of self-report to collect data on substance use, parental and school-related variables.

The study’s findings indicate a need to further understand the changes that occur in the parent-child relationship during the adolescent years and how protective factors are influenced by that change. Though it is only in specific variables that parents are able to play a significant role, it is important to recognize that parents are still significantly involved in the student’s decisions.

One study conducted by Van Der Zwaluw., et al 2009, examined the associations between adolescent alcohol use and participating adolescents’ perception of their partners’ alcohol use. The primary focus of this study was determining whether friends and partners tend to become like each other in relation to alcohol use, or do people instead tend to gravitate toward similar friends or partners.

To find the answer to these questions, researchers interviewed parents and adolescents from 428 Dutch families. These interviews were conducted once a year for four years. Each family participating consisted of two parents and two siblings with a retention rate of 81 percent across the study.

Across the study, both siblings participated in the process. For younger siblings, the mean age was 13.4 years; for older siblings, the mean age was 15.2 years. Those participants who reported romantic involvement at a given time within the study were used in the analysis. This included 36 percent of the older siblings and 26 percent of the younger siblings.

Through methods of self-reporting, researchers were able to capture information on the frequency of alcohol use during the past four weeks from the point of interview; whether or not the individual was in a steady romantic relationship at the time; and their own estimation of their partner’s frequency of alcohol use over the same four week time period.

The findings from this study indicate that when evaluating a participant’s estimation of their own alcohol use, as well as the frequency of their partner’s, participants and their romantic partners appeared to have relatively similar alcohol use habits and patterns. At the same time, a partners’ alcohol use did not appear to significantly predict later participant alcohol use if prior participant alcohol use was taken into account.

By contrast, the study did reveal that adolescents tend to select partners with similar drinking habits. Based on data gathered, a participant’s use of alcohol at a given time rather accurately predicted their partner’s alcohol use one year later.

This study did present certain limitations, the most glaring was the fact that data collected was dependent upon self-reporting, both for an individual’s own and a partner’s alcohol consumption. In some cases, the adolescent may have started dating earlier than most, which could skew the results.

Researchers concluded that adolescents and their romantic partners are similar in the amount of alcohol they consume. Based on study results, researchers suggest that this similarity is the result of initial selection of a partner and not the influence of a partner’s drinking habits on another adolescent.

• “I have an appointment” — It can be for a doctor, dentist, to get your carpets cleaned, car detailed, job interview – whatever. The point is, make it sound good. It always helps if it’s true, so before you go to a place where drugs and/or alcohol may be offered to you, have your way out planned in advance.

• “No way. I know what that stuff does to you.” — Simple, but effective, these words let the other party know in no uncertain terms that you’re not going to get involved. Say it like you really mean it, though, or they’ll just try to convince you.

• “I made a no-drugs/no-drinking pact” — The words you use here can be tailored to whatever you’re being tempted with. But these pacts – to not do drugs, to avoid alcohol – are becoming increasingly popular. If you have it printed on a laminated card, pull it out and show it. This lends even more credibility to your statement.

• “Big day tomorrow.” – This is a no-brainer. We all frequently have huge tests, a heavy workload or other important commitment requiring us to be alert and on top of our game.

• “I have to go to work.” – A job is a great reason not to get involved in drinking or doing drugs. It means you care enough to be responsible, and follow through on that obligation.

• “I’m going to a family outing.” — Plans with your family should always come first – in fact, you can even say that. Family is important. Your friends should understand that you have other commitments. If not, they’re really not your friends at all.

• “Late for dinner.” – You have to eat, right? Maybe it is a nightly or special dinner with your family, husband, wife, siblings, or other friends – it doesn’t matter who. You need to go, and that’s completely understandable.

• “It’s not my thing.” — This is a simple, declarative statement that tells the truth: you don’t want to become involved. Variations might be, “I think drugs are boring – I don’t like how they make me feel.”

• “I don’t believe in putting poisons in my body.” – Drugs and alcohol are poisonous to the human body, resulting in many negative and potentially lethal consequences. This is a strong statement that lets others know you’re adamant about your decision.

• “My family makes me toe the line.” – Family rules and discipline is a strong motivator to steer clear of drugs and/or alcohol. This statement is one that most teens can easily understand.

• “Coach subjects me/us to random drug/alcohol tests.” – Depending on the sport involved, this may be true. Be sure that it is, however, before you use it.

• “Alcohol/drugs run in my family.” – You don’t want to wind up like them, and you know there’s a strong likelihood of genetic and/or environmental influence. You’ve also seen the negative consequences first-hand, and definitely don’t want that to happen to you.

• “I promised my mom.” – Or dad, or whomever. The point is you made a promise that you intend to keep.

• “It’s against my religion.” – Most religions discourage, frown on or prohibit abuse, or use, of certain substances. If your religious belief encourages you to avoid alcohol and drugs, feel free to say so. Again, it’s always good to really believe in your beliefs before you say so. Your friends can tell if it’s a hollow statement.

• “I just went to confession.” – This is basically for Catholics, although it can be changed to suit another religious practice. If you’ve already confessed, you don’t want to go right back and get into trouble with alcohol and/or drugs.

• “I’m on probation or grounded.” – If you’ve already gotten into trouble with parents, school, workplace or other area, you may be “on probation,” or grounded and thus restricted from certain activities or friends. You’ll be watched and monitored closely, and can’t afford to take a chance with drugs and/or alcohol.

• “I’ve got a curfew.” – Doing drugs or drinking alcohol may make you lose track of time and miss your curfew. This can lead to your being grounded or losing other privileges. Friends should understand curfews – most teens have had them imposed at one time or another. Be firm, and make sure you leave when you need to – without doing drugs and/or alcohol.

• “I have to take my ___(mom, little brother, sister, etc.) somewhere.” — This is a variation on the appointment, but it’s for someone else. If you’ve committed to doing this, it’s something you need to take care of.

• “I’ve got my mom’s car and I have to pick her up.” – Many teens don’t have their own wheels, and borrowing one from a family member usually means there are limits – and obligations, like having to pick up your mom from work. It’s a good way to say “No” to drugs and alcohol.

• “No, thanks.” – This last statement is so simple and clear that nothing else needs to be said. You just respectfully decline. Good for you.

Parents know that peer pressure is a powerful force in teens’ lives. Not all peer pressure is bad, but some is very dangerous. Peer pressures to study hard, get good grades, excel in sports or other activities are often beneficial. When it comes to drinking and doing drugs, however, this powerful group force can have a very negative effect. Peer pressure can lead to teens making poor decisions, including those involving alcohol and drugs. But you can help your teens counteract the urge to go along with the group to drink and/or do drugs. What are some strategies to help teens cope with dangerous peer pressure?

Encourage thoughtful decision-making

It’s natural for teenagers to engage in exploration – of new ideas, concepts, clothing, food, etc. By encouraging your teen to make their own decisions in everyday activities, like how/when to do their homework and assigned chores, keeping family schedules, adhering to curfews, phone, Internet and television usage, you will help them establish sound and thoughtful decision-making habits. Once established, the ability to make such decisions can lead to teens being better able to say “no” when they are encouraged by other teens to engage in risky behavior.

• Making thoughtful decisions involves analyzing all aspects of the potential situation. Encourage your teen to identify decisions they may need to make in different situations. Help them gather enough information about the activity or event involving the decision in order to give them alternatives to the potentially risky behavior.

• Discuss as a family the kinds of actions teens can take. Some examples include sticking to family values, avoiding locations where underage drinking and drug use occurs, refusing to break the law, and others.

• Talk about the family ramifications to going along with peer pressure to drink and do drugs. These may include issues of getting grounded, the potential of being in an automobile accident with an intoxicated driver, being forced to have unwanted sex, etc.

• Encourage, but do not force, your teen’s decision not to drink until the age of 21. By the same token, reinforce the idea that taking prescription drugs for non-medical uses is not okay.

• Once your teens have identified potential decisions they’ll need to make, listed possible actions, and formulated their own decisions, stress that they are empowered to make their own decisions. This is important: tell them they have the courage and the ability to say “no” when confronted with peer pressure to drink and/or do drugs.

Be there for your teens

Teens are often unsure, insecure and need positive reinforcement. There’s no better place for them to receive this than right at home. Being a loving parent involves helping them to feel safe and secure in the family environment. It also means establishing an open and non-judgmental atmosphere at home where teens feel comfortable discussing problems and concerns. Let your teen know he or she is always loved, and that you are always there for them. Voice your pride for their accomplishments, bolster their confidence when needed, and engage in frequent family discussions on a variety of topics.

Provide examples of acceptable behavior

Don’t leave this to chance. Be sure your teens know what you mean by acceptable behavior. Topics don’t need to be only about drug and/or alcohol use. Cover teenage sex, smoking tobacco or illegal substances, school cheating, respecting others’ property, etc.

When in doubt, advise teens to walk away

There are going to be situations where your teens will encounter potentially dangerous activity, when they will be encouraged to “just try it” – whether that be some cool party drink (that could be laced with a drug), smoking a joint, popping prescription pills or other harmful substance. Stress that if your teen feels any uneasiness, that little “inner voice” that says “Don’t do it,” they should just walk away. They are in charge of their own STOP mechanism. Provide the atmosphere for frank and open discussions with them about just saying no – so that they’ll be better able to counter dangerous peer pressure when it does occur.

As the Saratoga News reported, the Prevention Needs Assessment Survey includes an anonymous student survey and an anonymous parent survey. It was designed to assess substance abuse amongst adolescents as well as to gauge anti-social behavior and protective factors that predict problem behavior.

“The results this year are a mixed bag. We are pleased with the middle school findings but are a little concerned with eighth-grade trends,” said Robin Ambrosino, Information Specialist at the Partnership for Prevention, in the Saratoga News report.

“At this age, the most important thing to kids is acceptance by peers. If dominant peers are using alcohol or drugs, others will probably follow. We need to focus more on the transition from eighth grade to high school.”

Administrators determined that one of the main factors driving alcohol and drug use is the students’ perception of how prevalent usage is among their peers. For middle school students, they know that use is low among their peers and therefore there is less pressure to try alcohol or drugs.

This perception makes a drastic change as students enter high school. By the ninth grade, most students believe that 50 percent of their peers are using substances. This false perception has driven the actual usage rate to 25 percent. Both numbers grow larger as the students grow older, showing that perception has more of an impact on reality than reality itself.

The results of these surveys does indicate that more needs to be done at the high school level to change perceptions and try to deter actual use. This could prove to be challenging as media coverage of celebrity use plays a huge role in the perceived glamour associated with substance use. Changing the behaviors of teens may mean changing things on a broader scale.