In a small, square garden behind a terraced house in Liverpool, Michelle Shevlin is showing me the tattoo she got soon after her only daughter died. “It already had the ‘Stephanie’,” she says, pointing to the name etched across her wrist. “Then I got the text of a Mother’s Day card she gave me: ‘A daughter holds your hand for a while, but holds your heart for ever.’”

Her partner, Sharon Taylor, nods. Her forearm also bears a new inscription – “I didn’t give you the gift of life, life gave me the gift of you” – as does the small shed, half bar, half tiki stand, squeezed into the garden behind her. A plaque is screwed to the front: “In loving memory of Stephanie Jade Shevlin, 1993-2016. Forever watching over us. So drink up and dance.”

They remember the Saturday night Stephanie died; it was only hours after they had started building the bar. Michelle had gone to bed early. Just before 1am, she got a phone call from the hospital. They drove there immediately, but she didn’t make it in time to see her daughter alive.

Stephanie died in the early hours of 5 June last year after taking ecstasy on a night out. The 22-year-old had gone to the Box nightclub in Crewe for a rave called Core Blimey with her girlfriend of five years, Ann Roberts, and a small group of friends. Ann speaks quietly as she recounts the events of that night. She says she is unhappy that previous news reports made Stephanie out to be “a druggie”. “We only did a summer rave and a new year’s one,” she says. “That was it. Twice a year.”

The group bought pills from “some lads” they met that night. “We took our first half in the toilet and another one on the dance floor,” Ann says. “We all took the same amount.” At around midnight, Ann says, the group began to notice Stephanie go “a bit funny, falling around everywhere”. That was when an ambulance was called. It is difficult for her to describe the journey to the hospital. “She couldn’t even respond to me,” she says, her voice growing quieter. Stephanie died later that night.

Deaths linked to ecstasy or MDMA are at their highest in a decade. In 2010, there were eight; in 2015, there were 57

It was a hot night; drinking too much water may have been a factor, as it has been in other ecstasy-related deaths. But a coroner’s report in November last year found that Stephanie was killed by a “high concentration of MDMA [the active ingredient in ecstasy] in her blood”, even though she had taken only the same quantity of drugs as her friends.

Although she had taken ecstasy a small number of times before, Stephanie couldn’t be described as a clubber. She was more into gaming and was hoping to study game design. In the meantime, she worked at Southport Pleasureland, operating the rides. She was part of a strong community that grew up at school together; around 300 people showed up to her funeral in bright colours and SpongeBob SquarePants T-shirts, a homage to her favourite cartoon character.

For her mother, this is an easier memory than the night she arrived at the hospital. “I couldn’t go in and see her,” Michelle says, her face wincing. “They asked, but I couldn’t. I had the image in my head – I didn’t need to actually see her.” She looks back down at her tattoos and half smiles. “Hopefully, she can see the pain we went through getting them.”

Facebook Twitter Pinterest Stephanie Shevlin, who died after taking ecstasy in 2016. Photograph: Courtesy of Michelle Shevlin

More people are taking ecstasy than ever before – and more people are dying from it. According to the Office for National Statistics (ONS), about one in 20 16- to 24-year-olds report having taken ecstasy in the past 12 months; the Global Drugs Survey (GDS) found an increase in use among UK clubbers of 16% between 2014 and 2016.

Mostly, they are young people taking drugs, occasionally, for fun. Last month, 22-year-old student Joana Burns died after taking MDMA during her end-of-university celebrations in Sheffield.

This follows a string of similar stories over the past two years. In 2016, weeks before Stephanie’s death, 17-year-old Faye Allen died after taking a pill “double the normal dose” at Victoria Warehouse in Manchester. Six months before that, 19-year-old John Milburn and 47-year-old Andrew Glaister died after taking ecstasy at Cream in Liverpool. They were unacquainted; the coroner described their deaths as “a bizarre coincidence”. Last August, Fabric nightclub in London temporarily lost its licence after the ecstasy-related deaths of two 18-year-old boys.

According to figures released by the ONS towards the end of 2016, deaths linked to ecstasy or MDMA are at their highest level in a decade. In 2010, there were eight; in 2015, the count was 57. According to last year’s Global Drugs Survey, in which more than 100,000 drug users worldwide were quizzed about their habits, this is “the worst time to be using MDMA in a generation”.

MDMA, also sold in powder form, is at its purest in years, being recorded by drugs charities at 83% purity, sometimes more. New, cheaper methods of production mean that manufacturers, many of them based in the Netherlands, have no qualms about making ecstasy stronger than ever, with some competing to produce the most potent product: pills can contain triple the typical dose found in the 90s.

Fiona Measham, a professor of criminology at Durham University, conducts on-site drug testing at a growing number of venues and festivals around the UK. She does this through her charity, the Loop, with the support of health services, the police and local authorities. The charity uses state-of-the-art infrared lasers that can analyse a drug sample in fewer than 60 seconds.

For the past three and a half years, the Loop has been based at Manchester’s Warehouse Project, which remains the only club in the UK with on-site drug testing. The team conduct tests on confiscated substances; if they find a dangerously strong or adulterated drug in circulation, they put out a warning on social media. But it is at festivals that the charity is having the biggest impact.

Last summer, the Loop collaborated with the drug-reform thinktank Trans

form and Cambridgeshire police to launch the UK’s first drop-in drug-testing facility at the Secret Garden Party festival in Cambridgeshire. A quarter of the people who went for testing asked for their drugs to be discarded, because they weren’t what they thought.

Last month, the Royal Society of Public health (RSPH) called on all music festivals to provide a testing service “as standard” – a move it claims is backed by 95% of festivalgoers and 90% of clubbers. “We accept that a certain level of use remains inevitable in such settings,” said Shirley Cramer, the RSPH’s chief executive. “We therefore believe that a pragmatic, harm-reduction response is necessary.” This year, Festival Republic, the promoter behind some of the UK’s biggest festivals, announced that it hopes to have testing tents, run by the Loop, at between six and 10 of its festivals, including next month’s Reading and Leeds, pending final approval from the Home Office.

It is difficult to negotiate, because drug-testing areas are essentially decriminalised zones where festivalgoers can have their drugs tested without fear of arrest. The police agree to stay away; public safety is the priority.

From Emily’s side of things, if she could have tested [her drugs], would things have been different? Possibly, yes

“Festivals are like mini-republics,” Measham says. “It’s easier for them to try new things and set their own policies than it is for clubs.”

Fabric’s closure in 2016 sent a shockwave through the industry. “If Fabric could be closed down, then anyone could,” Measham says. “It made commercial venues think twice about their own vulnerabilities. Last year, there were about six to 10 ecstasy deaths at festivals, which is around one a week over the season. This is a scary thing for licensees.”

Through the Loop’s work at festivals (where, according to Measham’s research, up to one‑third of those attending could be taking class A drugs, such as MDMA), Measham is able to give a detailed insight into what is in circulation. When it comes to ecstasy, she says, the biggest risk now is not that it may have been adulterated, but the strength. An average dose of MDMA is considered to be about 75-80mg; at present, the average ecstasy tablet contains 100-150mg. It is not uncommon to find pills containing double this.

Measham’s research has found huge variability. This, she says, is one reason for the increasing death toll, because it makes it easy to misjudge consumption. At last year’s Parklife festival, she tested a “Louis Vuitton”-branded pill that contained 20mg of MDMA and a “Mastercard”-branded pill that contained 250mg, more than 12 times as much. “If someone has two Louis Vuittons and is a regular drug user, they’ll barely notice it,” she says. “But two Mastercards – that’s half a gram of MDMA. If someone’s small, slight and inexperienced, well, that could kill them. You’ve got something with almost no effect and something potentially lethal, both circulating in one festival on one day.”

Measham is at pains to point out that testing alone can’t remove all danger. “Five friends go out one night and take ecstasy; one doesn’t come home. They’ve all had the same drug in the same venue. There’s an X factor here that we’ve still not really pinned down.”

The limited information available to researchers makes it hard to pinpoint this X factor. Did they share their drugs with friends? Did they eat dinner that night? Did they drink? Take other drugs? What was their drug tolerance? “Young people, especially, might have an undiagnosed condition, like congenital heart disease,” Measham says.

When someone takes MDMA, the drug causes the brain rapidly to release serotonin, a neurotransmitter that contributes to the regulation of behaviours such as mood, appetite and sleep. This is what creates the overwhelming sense of empathy and euphoria that most users describe.

As with all drugs, however, there are side-effects. It affects the so-called antidiuretic hormone, which causes the body to store water. Drinking too much can be fatal. Other dangers include malignant hyperthermia, a potentially lethal rise in body temperature, and heart attacks. Some people are simply genetically predisposed to metabolise MDMA less well than others – and there is no way to know this before you take it.

Facebook Twitter Pinterest Emily Lyon, who died after taking MDMA in 2016. Photograph: Courtesy of Steve Lyon

At about 5.30pm on 17 June 2016, 12 days after Stephanie’s death, 17-year-old Emily Lyon left her family home in west London and made her way with friends to the O2 Arena for the Red Bull Culture Clash. She had just finished her AS levels and was celebrating her new freedom. As her father, Steve Lyon, puts it: “It was wind‑down season.”

They are a close family, he tells me when we meet in a cafe in Teddington, south-west London. Emily was incredibly sociable. His face lights up when I ask him to describe his daughter: “She seemed to be able to connect with people of all ages: her peers, younger people, our friends. She was very popular. She liked going out. She’d been building up to this event for a while. The excitement was mounting daily.”

Steve still doesn’t know the details of that night, but has been able to piece together some of it by speaking to his daughter’s friends. It was perhaps the second or third time she had taken MDMA. “Does it surprise me?” he asks. “Maybe a little bit. I’m not condoning it, but I don’t think she was under pressure to take it. Not all of them were doing it, but it seemed to be just a socially acceptable thing to do.”

At a coroner’s hearing in February, it was revealed that his daughter had taken a quarter of a gram of MDMA powder on the train to the concert. On arrival, seeing sniffer dogs on the door and fearful of being caught with the drug, she took another quarter of a gram, the rest of her stash. (Her death is one of a series of accidents that suggest drug-detection dogs are a danger to punters, rather than a deterrent. Two ecstasy deaths in Australia have been linked to the presence of sniffer dogs.)

Steve tells me that his daughter was dancing in the crowd when she became unwell; her friends took her to one side to help her. Then she collapsed. Paramedics were called and she was taken to hospital just before 10pm. She died about three hours later.

Steve was at a gig himself that night, at the 100 Club on Oxford Street in central London, when he got a call from his wife to say something was wrong. He rushed across the city to find his daughter in hospital with a medical team trying to save her life. “It was too distressing to watch,” he says. “I had to go back into the waiting room. Then they came out and said they couldn’t do anything for her. That was it – devastating.”

One of Emily’s close friends, who asked not to be named, still “relives every day” the night she died. They had been friends since they were 11 –playing in the same cricket and netball teams – and became closer as they grew up. She describes Emily as the “loudest person”, who “loved to socialise with everyone”. “I love the person she made me,” she says. “It’s hard to come to terms with not having someone who had such an amazing impact on me.”

When Emily’s friends set up a crowdfunding page in her memory, her family requested that the Loop be one of the charities to benefit. “I think it’s almost impossible to totally prevent people taking drugs,” Steve says. “Anything that can help to make it safer is good, in my opinion.”

Emily’s friend agrees. “It’s about having the knowledge – knowing the signs of when it’s gone wrong and knowing what each drug looks like. Half the time, teenagers do not know what they are taking or how much. We are all told it is bad, but that won’t stop people from doing it.”

Charities such as the Loop have been working hard to educate users. Its Crush, Dab, Wait campaign encourages people to think carefully about how they consume their MDMA and advises them to crush the crystals into a fine powder, have one dab with a finger and wait an hour or two before taking more. As Dr Adam Winstock, the founder of the GDS, says: “We need education that understands that pleasure is the thing that drives drug use. Our message is: if you want to have more fun, take less.”

Last August, music magazine Mixmag collaborated with GDS to launch a similar initiative, Don’t Be Daft, Start With A Half, which encourages those taking MDMA powder to take less than 150mg in a session, in two or three doses. With pills, it means having a half or a quarter at a time. The campaign also recommends not taking ecstasy more than once a month and not mixing it with other drugs or alcohol; last year’s GDS found that 90% of those who sought emergency medical treatment had either been drinking or taking drugs.

***

In Swansea, I meet Nadia Rees, the mother of Ben Rees, who died in July 2015, aged 23, after taking what he thought was ecstasy on a trip to Berlin. She already worked in the harm-reduction field, supporting drug and alcohol users, but since her son’s death has been doing more research into the issue. She has brought sheets of paper scribbled with facts and statistics from various reports on drugs, as well as notes from Ben’s friends, describing what he meant to them. She hands one to me, tearful. “Ben taught me that it was OK not to follow the crowd, but to be your own person,” it reads.

We are at a bar in the city centre along with a close friend of her son, Gary “Big G” Lulham, and Hollie James, who was Ben’s girlfriend. They tell me he made a big impression in Swansea, working at the club Sin City, a venue run by Gary, as well as promoting events, including the university summer ball, and DJing. “He was well known,” Gary says. “A bit of a BNOC.”

“A what?” Nadia asks.

“A big name on campus,” Hollie says. “But I don’t think it was just because of the promotion. I think he was well liked because of the person he was. He definitely changed me as a person.”

His phrase, Nadia says, was always: “What are we going to do next?” He was constantly working on new projects and would turn up at Sin City unpaid just to bounce ideas around: one of his last was DJ workshops to encourage more women to take up the skill.

“Couldn’t just sit down and have a cup of tea, could he?” Gary says.

“Try living with him, Gary!” Hollie says.

People need information. When it’s criminalised you don’t know what you’re getting

Organising was Ben’s strong point. He had orchestrated a trip to Melt festival in Germany with a group of friends. The trip began in Berlin. On the Wednesday evening, he went to a club with a friend. By the time he started to feel unwell, they had become separated. He was found at a train station by a group of girls, who took care of him until he was taken to hospital, where he was resuscitated twice before dying from a cardiac arrest and multiple organ failure.

Nadia, her husband and Hollie arrived in Berlin the following day. “The boys were waiting for us at the airport,” Nadia says. “Love ’em. They were all amazing, really. They were in shock, but they were very supportive.”

When the toxicology report came through, it showed MDMA and a higher level of paramethoxyamphetamine (PMA). PMA is far more toxic and slower to kick in, making it much easier to overdose; users can think the drug isn’t working, so they take more. It emerged several years ago, at a time when MDMA was in short supply, following an international crackdown on the chemicals used to make it.

Nadia wants more transparency. “People need information,” she says. “I know how much nicotine is in these cigarettes. I know how much alcohol is in this wine. But when it’s criminalised you don’t know what you’re getting. I feel that if we had a drug-testing system in the UK it would be the norm that, if you bought something, wherever you were, you’d go get it tested.”

This is what a lot of users do in the Netherlands. Every week, a network of about 30 testing facilities gives them the opportunity to hand in drugs for analysis. The state-funded Drugs Information and Monitoring System (Dims) is an impressive operation; in 2015, it handled almost 12,000 samples, with ecstasy making up the majority. It started 20 years ago, doing basic tests at clubs and festivals around the country.

The Netherlands then was more or less at the stage the UK is now, according to Dims research assistant Daan van der Gouwe. “Our system really saves lives,” he says. “Whether it’s good or not to take drugs is a different issue, but imagine if you’re the parent of a child using drugs occasionally… I know I would prefer they had a chance to know what’s inside the tablet, rather than waiting to see what happens.”

Whenever Dims comes across an alarming sample, it alerts the national media. At the end of 2014, a “pink superman” pill was handed in for testing. It contained no MDMA, just a lethal dose of PMA, the chemical that most likely caused Ben’s death. Dims immediately issued a warning on TV. The drug disappeared from the market in the Netherlands and no incidents were reported; in the UK, four people died after taking the pill. One of the few people to issue a warning in this country was Fiona Measham, who posted about the drug on social media.

Measham hopes the UK will be able to expand its pill testing beyond festivals, but she has faced resistance from local authorities. A common fear is that it could encourage more drug use. At one of the festivals where the Loop has provided a welfare service for a number of years, it hoped to introduce a testing tent (rather than only testing confiscated drugs), but couldn’t get permission, according to Measham, due to the fear that a drug-related death would generate bad press. “Our response was: ‘Yes, but what if there was a dangerous pill circulating with 75,000 people on site?’” Measham says. “You could get a lot more than one drug-related death. Then the question would be: ‘Why didn’t you have our drug safety testing on site? It’s shameful that the number of drug deaths has gone up in the UK when we have more information and evidence than ever before.”

Meanwhile, the unpredictability of ecstasy (more so than other class A drugs) remains an uncomfortable reality. Even with the limitations of drug testing, the growing acceptance of this approach allows the sharing of advice and support that could save lives. It is a move that many are keen to embrace, from researchers to clubbers and police officers to parents.

It is just over a year since Emily died. That year has been punctuated by many similar tragedies. For her father, stories of other young people dying after taking drugs have brought back terrible memories. “For me, [every death] feels like another life lost that could have been avoided with better information,” he says. “From Emily’s side of things, if she could have tested [her drugs], would things have been different? Possibly, yes. Probably, even. But then, by doing that, you’re almost turning a blind eye to drug taking.”

As for how the family is coping, he tells me they are strong, but struggling. “There’s not a morning, afternoon or evening that goes by without us all thinking about Emily. She was a big personality in our house and left a big hole.”

• This article was amended on 25 and 26 July 2017. A reference to a man dying and four others being hospitalised in Manchester is now thought to have been caused by the drug spice. This reference has been removed. The name of the PMA pill has been changed from red superman to pink. A sentence saying Fiona Measham was the only person to issue a warning has been changed to say one of few people.

