Called the choking game, the pass-out game or even California knockout, it has resurged among kids and young teens who see it on online video-sharing sites.
The choking game, in which a person uses auto-asphyxiation to pass out just for the rush of it, is not new. It's been around for years. But now kids are getting their friends to film them doing it and posting the videos on YouTube, which has breathed new life into this dangerous fad.
"I think the word 'game' sort of messed everybody up. They think it's just fun, like nothing's going to happen," said Simon Greiner, a sixth grade student from Santa Monica, Calif., who recently attended an awareness meeting run by the advocacy group Erik's Cause: Help Stop The Choking Game.
Peer pressure to try the choking game can now come from a stranger on the Internet, and curious kids can look up a variety of ways to constrict oxygen to the brain, get a quick buzz and prove to their friends that they can take on the "challenge." But several kids accidentally kill themselves in the process.
Judy Rogg launched Erik's Cause after her son Erik died two years ago from the deadly game.
"A lot of kids make it look fun," Rogg said. "They're laughing. They don't realize the kid's on the floor twitching because he's having a seizure."
"A lot of kids say, 'Well, at least we're not doing drugs,'" Rogg continued. "They think it's an alternative, and they don't understand that they're killing brain cells."
Erik was 12 years old, a Boy Scout who had just earned his Marksmanship badge, when his mother found him dead after school one day.
"He took his Boy Scout rope and made very, very intricate slip knots," basically hanging himself, Rogg said. Before her son's death she said she had never heard of the "choking game."
"The police, they said, 'This was not a suicide this was the choking game," and we looked at them and said, 'What are you talking about?" she said.
Dr. Thomas Andrew, the chief medical examiner for the state of New Hampshire, said data indicated that between 7 to 15 percent of all kids had tried some form of the choking game -- in other words, thousands of kids. Whether the method involved pressure on the neck or hyperventilation, he warned any attempt was dangerous.
"Seizures, brain damage, chronic headaches and close-head injury or death," Andrew said of the risks.
He added that the choking game should be on the radar screen of every youth mentor, scout leader, teacher, counselor and parent, because it is far from harmless fun.
Derek Gall, a high school sophomore from Randolph, Neb., said he learned the dangers of the "pass out game" the hard way when he tried it at school one day.
"I just got curious and looked up several different ways to do it. I found what seemed like the safest one to do," he said.
Gall found a video on YouTube that claimed to show a "safe" way to "pass out." The boy in the video said, "So what I'm about to show you is completely safe, don't listen to other people." He then proceeded to hyperventilate -- all caught on his webcam -- before crashing to the floor and hitting his head on furniture. The video has since been taken down by YouTube for violating their Community Guidelines .
Curious to see if it would work on himself, Gall tried the same thing at school the next day. He passed out, collapsed and smashed his head on the hard concrete floor, fracturing part of the right side of his skull.