I only see what remains to be done. A 6 foot 4 inch 300 lb. We meet an 80 year old lady with altered mental status and dismiss cocaine use. The same scenario in a young man with multiple tattoos is handled differently.
Assumptions are sometimes wrong.
Most people assumed the sun revolved around the Earth until Copernicus came along. We are often aware of the assumptions we make. We even pass them down to our residents and students. When a person begins to ask for narcotics by name and dose, you should be on guard for drug seeking behavior. When a patient is intoxicated, you should assume they cannot make rational decisions and protect them, even against their will.