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Doctors and nurses can't always tell if someone's drunk or on drugs, and misdiagnosis can be dangerous

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Bob has arrived at the emergency department at 10am on a Tuesday after breaking several fingers slamming his hand in a car door. Bob is quite anxious; he speaks quickly and paces around. When asked to sit and explain what has happened, he provides an articulate account of events. A look at past medical records indicates Bob has recently been admitted to hospital for alcohol withdrawal. Bob's blood alcohol concentration is 0.35% (or 0.35 grams per decilitre). For the average person, this could be fatal. But Bob is sitting upright with little outward cues he has been drinking heavily.

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