An Internet drinking game called “Neknomination” reportedly led to the death of two young men in Britain this week, according to ABC News. In the game, a person quickly drinks a concoction of alcohol, sometimes mixed with other ingredients, then nominates two other people to do something even more outrageous. The results are posted online.

The drinks can include ingredients such as protein powder or even engine oil. Some participants have performed back flips and other athletic feats while drunk, or have been drinking while driving. The game started in Australia, and has become popular in Britain. This week, Canadian newspapers have begun to report the game is catching on there.

Rosanna O’Connor, Director of Alcohol and Drugs at Public Health England, said, “The game’s encouragement of participants to outdo each other with ever more reckless stunts brings with it significant risks of alcohol-related harm including acute intoxication, accidents and injury. There is also the potential for cyber bullying of those who are seen to ‘chicken out.’ It has already cost lives and we would advise anyone against taking part in the game to avoid putting themselves in a potentially dangerous situation.”