The majority of cases (40 out of 42) were admitted under cardiology services, while one patient was admitted to the general Intensive Care Unit and another one to a general medical ward. Most cases were identified through the positive cardiac biomarkers, while only three cases were coded for substance abuse upon discharge. Details of the cardiac investigations that were performed in the 42 patients are shown in Table 2. Diagnosis of ACS/myocardial infarction (MI) was made in 31 cases (74%), while other complications were less frequent (Fig. 3). Cardiac procedures and other clinical outcomes are shown in (Table 3). Despite the perceived trends of increasing UDS over the study period, the ATS positivity rate has fallen by 50% between 2006 and 2013 (Fig. 4). Individuals older than 40 years were noted to have higher proportion of diabetes mellitus and were more likely to present with ACS, while admitting drug abuse was more frequent in younger population (Table 4).