Does intentional asphyxiation by strangulation have addictive properties?

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 comorbidities. There does not appear to be strong evidence of seeking support for cessation of the practice. Conclusions 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.

Unexpected Penile Tumescence in the Elderly

“…Hypoxia-induced erection may also play a role in sexual gratification during self-induced hypoxia such as strangulation. Such self-induced hypoxia may result in accidental death [4].…”

Breathing: a Powerfull Tool for Physical & Neuropsychological Regulation. The role of Mobile Apps

“…The intentional acute starvation of oxygen through hypoxia can shift consciousness to a euphoric state and leads to transcendental experiences. However, it carries a serious risk of accidental risk (Chater, 2021). Nisshesha rechaka pranayama, a breath-holding technique, is the simplest technique to produce intermitted hypoxia (Malshe, 2011).…”

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The Mental Capacity Act 2005 and autoerotic asphyxiation: pleasure versus the risk of harm

“…He was known to have interests in certain sexual practices, including autoerotic asphyxiation (AEA in the judgment) – the deliberate self-induction of cerebral hypoxia with the intent of causing heightened sexual arousal or orgasm. It has an inherent risk of severe physical injury and even death (Chater 2020). Deaths attributed to autoerotic asphyxiation are predominantly in males (Byard 2012).…”