Everything you need to know about the most popular drug at Schoolies this year.

She’s spent the day swimming in the ocean and lying by the hotel pool, surrounded by friends and celebrating Schoolies on the Gold Coast. Her wristband glows on her forearm as she dresses for a night of partying among the rest of the nation’s school leavers.

There are more pills than there have been in previous years. The drug MDMA is easy to buy. It’s cheap, retailing for between $20 and $30 a pill, according to the 2016 Global Drug Survey. The hangover reportedly isn’t as sickening as alcohol and it won’t make her tired.

Her friends have told her about the feelings of euphoria and body tingling that last several hours. But what she isn’t expecting – what no one has told her – is how her racing heartbeat will make her scared. How she’ll look around, wondering if people can see her chest pounding through her T-shirt. There is the anxiety that something is about to go terribly, horribly wrong. There is the increased body temperature, extreme thirst and the urge to vomit.

This year, twice as many female school leavers have been treated for intoxication and drug use than males at Schoolies on the Gold Coast, Seven News reports. On Sunday night, paramedics treated 95 people and transported two to hospital. On Monday night, it was 89 people treated on Cavill Avenue and six taken to hospital.

It’s only day four.

“Interestingly we have noticed that on both evenings so far the number of female patients we have had has doubled the number of male patients,” Queensland Ambulance Service special events co-ordinator Justin Payne told the Gold Coast Bulletin yesterday. “It’s a little bit concerning.”

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According to Payne, MDMA is the drug of choice.

MDMA, also referred to as ‘Molly’, is a psychoactive chemical called 3,4-Methylenedioxymethamphetamine and can be taken in pills or as a powder. Ecstasy is MDMA pressed into a pill, usually alongside other substances.

In 2016, according to the Global Drug Survey, the world reached ‘peak’ MDMA.

There had never been more of the drug in circulation and the pills being sold were the strongest ever. Australia saw a 12.7 per cent increase in the use of MDMA between 2015 and 2016, as reported in the survey.

“At the moment, MDMA pills seem to contain one of the highest doses that they’ve ever contained,” one of the study’s co-authors, Dr Monica Barratt from the National Drug and Alcohol Research Centre at UNSW, told ABC’s HACK last June.

“Some pills contain between 250 milligrams and 300 milligrams of MDMA. Novice users are more likely to come to harm by just taking one pill than they would have in earlier years – when pills tended to be 80 to 100 milligrams.”

The problem has continued into 2017, with high amounts of MDMA still in circulation – on Monday, police uncovered more than 24,000 ecstasy tablets in a home in north Brisbane, believed to contain MDMA and bound for Schoolies, Nine News reports.

And the MDMA being sold is still dangerously high in concentration and purity – in February this year, more than 20 people were hospitalised, and three died, from a “bad batch” of MDMA circling Chapel Street in Melbourne. And, just weeks ago, 20-year-old Amy Vigus in the UK died from a lack of oxygen to the brain due to MDMA toxicity, BBC reports. She’d taken a pill at a music festival and didn’t wake up the next morning.

Amy Vigus ecstasy death after Elrow Town Festival ‘accidental’ https://t.co/a749Ifb6BO #London pic.twitter.com/egnvE5riqw

— London News (@DaiIyLONDON) November 21, 2017

According to the Alcohol and Drug Foundation, adverse affects from MDMA include:

• Floating sensations
• Hallucinations
• Out-of-character irrational behaviour
• Anxiety
• Irritability, paranoia and violence
• Vomiting
• High body temperature
• Racing heart beat
• Fitting

There is also the way MDMA can interact with other medications such as alcohol, antidepressants, or cold and flu medications to cause a potentially lethal overdose.

As well as this, taking MDMA messes with the body’s hydration. It causes the release of the hormone cortisol – which increases heart rate and causes sweating – but it also releases vasopressin, which is a water retention hormone. This combination means users are at risk of both dehydration or over-hydration – something a 17-year-old school leaver dancing and sweating and drinking alcohol at a beach party is not likely to understand.

It’s young women who are at the greatest risk of adverse effects.

“[The 2016 Global Survey] showed 1.5 per cent of women who used ecstasy in the previous 12 months reported seeking emergency medical treatment, and for men it was 0.9 per cent,” Dr Barratt told the ABC.

We’re seeing the same trend on the streets of Schoolies this year, where twice the number of females are being treated for alcohol and drug related problems, compared to males.

The main reason for this discrepancy is body size and weight, according to the Alcohol and Drug Foundation. And last year, the Global Drug Survey launched a campaign called ‘Don’t Be Daft, Start With Half’, trying to encourage users to start slow because the dosage, relative to body size, matters.

A person’s history using the drug also affects tolerance, with Dr Barratt telling the ABC: “If you’re 17 or 18 and just starting to use these drugs, you could actually get a very strong product which could lead to overdose.”

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There are many potential reasons young school leavers are using MDMA.

It might be that it’s cheap. It could be that police are targeting underage drinking at Schoolies and taking a pill seems easier than smuggling alcohol. It might be that the stimulant effect of MDMA is such a contrast to the sleepy, depressant effect of alcohol.

It could simply be that it’s ‘trending’.

“Ecstasy use in Australia fluctuates. It was increasing before 2010, and we saw a decline in use between 2010 and 14, Now, it seems to be increasing again,” Professor Alison Ritter, who is the Director of the Drug Policy Modelling Program at the National Drug and Alcohol Research Centre, told Mamamia earlier this year.

Whatever the reason, there has never been a more important time to talk to your teenager about MDMA and the risks associated with taking it.

She, who might be lying by the pool, or readying herself for a beach party, or listening to her friends talk about ‘euphoria’ will at least know the side effects and understand when to seek help.

It’s not hysteria, it’s fact: Young people are taking MDMA and young women are at greatest risk of being harmed. The most dangerous thing to do is to look away.