Start by broadening your definition of “substances.” Think beyond alcohol. Consider nicotine, energy drinks, supplements, performance-enhancing drugs (PEDs), cannabis, or even excessive caffeine use.
Be curious, not clinical. Try asking: “What’s in your bottle today?” Sometimes being a little nosey opens the door to big insights.
Pay attention to behavior and body language. Vague answers, hesitation, or defensiveness can be cues to dig deeper — gently and respectfully.
When working with youth, build trust before intervention. Younger people may see medical appointments as punishment. Make space for honest conversation before bringing in a parent.
Support harm reduction, not perfection. Don’t aim to “fix” everything. Helping someone reduce their intake — or understand what they’re consuming — is a meaningful win.
Use your strengths as a DCES. Problem-solving, active listening and empathy are powerful tools that DCESs possess. Don’t underestimate the role you play.
As a DCES, you may be the only professional on your client’s care team who has the time to ask detailed questions about what they are actually consuming — and how it makes them feel. Opening a door for supportive, nonjudgmental conversations rooted in harm reduction can make a huge difference in the lives of those with diabetes that we care for.