The drinking game “neknomination,” which involves people posting videos of themselves chugging alcohol, has taken an even more dangerous turn after some participants made the switch from beer to hard liquor.

The latest online craze involves people recording themselves chugging or “necking” alcohol while often doing something extreme at the same time. They then nominate others to out-do their feat within 24 hours. Thousands of “neknomination” videos have been shared across the globe.

The drinking game, which is believed to have originated in Australia, has made its way to Canada and has health officials in Canada concerned.

“Those are disturbing trends if they in fact do become bigger than what is currently taking place,” said Nova Scotia Health Minister Leo Glavine.

And as the trend spreads through social media, the drinking challenges become more dangerous.

“Initially it was for beer, and now it’s moved into hard liquor, and that’s when we get really concerned,” said Dr. Connie LeBlanc.

Alcohol poisoning isn’t LeBlanc’s only worry. The Halifax doctor says that some of the nominations involve people drinking in the middle of the highway or in a swimming pool. “They’re doing things way outside your normal boundaries and there’s a lot of peer pressure around this,” she said.

The online drinking craze has already been blamed for the deaths of two Irish men.

Jonny Byrne, 19, died after jumping into a river during a “neknomination” stunt on Feb. 1. Just hours earlier, Ross Cummins, 22, was found unconscious in a friend’s house in Dublin.

The trend is proof of how quickly social media can spread a movement, according to one social media expert.

"Once something becomes worthy of sharing, it has the potential to spread like wildfire and this is classic example of that," Phil Pallen told CTV Toronto.

While health officials can’t prevent individuals from participating in the drinking game, they say they hope people won’t give in to peer pressure, and that they drink responsibly.

"Anybody who gets involved in this is at risk and it is dangerous," Shamez Kassam, an EMS superintendent, told CTV Toronto.

But “neknominations” aren’t just about drinking. The trend has since been turned on its head, with some people using it as a way to “pay it forward.”

From donating clothes to giving food to the homeless, the trend has taken on a life of its own.

"I think one of the things we’re trying to do is doing something really cool, random act of kindness out of such random act of stupidity," said one man in South Africa who donated soccer balls to young children.

With a report from CTV Atlantic’s Matt Woodman and CTV Toronto’s Ashley Rowe