Rachel Knight was in junior high school the first time she let a classmate wrap their hands around her neck and squeeze until she passed out.

It was supposed to be fun, a way to get high, a rush of endorphins as oxygen streams back into one's brain as they regain consciousness.

It wasn't, she said. "I went to sleep and had a dream. It seemed like it lasted forever, but when I woke up it was only two seconds later," the 18-year-old Mandeville High School senior said. "It was dumb. I was scared, and now nobody even knows the consequences."

Today, the game called Suffocation Roulette, Rising Sun, Flatliner, Hangman, Space Cowboy and a bevy of other names has become more prevalent and fatal than ever before with deaths ranging between 43 and 1,000 students a year, according to a host of non-profit agencies advocating the game's dangers.

And with the Internet streaming YouTube videos of participants, incidents are reported in St. Tammany and as far away as Guam, India, Peru, Ireland and Korea with today's adolescents often constricting their necks with ligatures such as dog leashes, belts, bungee cords, bathrobe ties, sheet and ropes instead of their hands, according to The DB Foundation, a St. Augustine, Fla.-based non-profit agency aimed at educating parents.

"Everybody is doing it, even the good kids," said Vinny Williams, a 14-year-old eighth-grader at Fontainebleau Junior High School who called the game "stupid."

Earlier this year, Williams said, several students at his school were caught playing the game in a bathroom. Six students were later found to be involved, and shortly thereafter they were all suspended, Williams said. School Board spokeswoman Linda Roan confirmed those students were disciplined but declined to confirm the suspensions citing privacy rules.

School administrators there have since held assemblies warning of the game's dangers and have shown cautionary videos to students in physical education class. The St. Tammany Parish School Board feels it was an isolated incident.

"It's not a common occurrence," Roan said.

Yet experts say the game occurs everywhere - at home, at parties and even during team sport events - where 90 percent of the participants are males between the ages of 9 and 16, said Kate Leonard, the DB Foundation founder.

"It's mind boggling why you would do something like this that can be so deadly," Leonard said.

Leonard knows first hand. In 2005, she was sitting in her living room, 15 feet away from her 11-year-old son Dylan's bedroom.

Suddenly, a pang of motherly instinct shot through her.

"I knew it was too quiet," she said. "Something was wrong."

She got up from her seat and approached Dylan's room. She froze. Dylan was hanging from his bunk bed, a noose tied around his neck.

He was dead.

Pain and fear coursed through her veins. She thought her son committed suicide.

"I thought I really missed something big," she said.

It was only later that doctors informed her of the choking game.

Dylan was its latest victim, they told her.

Since then, Leonard has traveled the United States speaking to student groups, troubled youth homes and "anybody that will have me," she said.

"I've been talking about this for two years, and it still blows my mind how many kids are doing it," she said.

A survey commissioned by Leonard's foundation suggests 75 percent of youths and teenagers have played or have heard of the game, while 25 percent of parents are clueless.

"The whole phenomenon has been going on for generations and generations," Leonard said, adding an 80-year-old approached her at a forum and admitted he played it as a child. "And if it skips a generation, parents know nothing about it. This is what's happening now."

Knight however, can't believe kids are still even playing the game.

She thought it was a childhood fad, one that faded over time. With her friends the practice ended quickly when one friend passed out and awoke in seizures. Another time, a friend passed out, hit her head and woke up, unable to feel the welt, she said.

"I think that is when everybody said that's enough," she said.

Yet it continues.

In the past, the game was mostly performed in groups with participants either succumbing to peer pressure or feeling a sense of security with others around, said Daryl A Lynch, a doctor at the Children's Mercy Hospital in Missouri.

"But a recent trend is that the game is played alone which also increases the risk of dying from a ligature that does not loosen, as expected," Lynch wrote in an essay for the hospital, "The Choking Game - A Deadly Game is Resurfacing."

Dylan Leonard was one such victim, his mother, Kate said.

At the time she had no clue the game even existed.

"That's the bottom line," she said. "If you don't know about it, there is no way to warn your kid."