This article by Leo Shane III originally appeared on Military Times, the nation's largest independent newsroom dedicated to covering the military and veteran community.

Substance abuse problems among veterans are on the rise, but it can take weeks or months to access care through the Department of Veterans Affairs because of a confusing morass of bureaucratic hoops, according to advocates who testified before Congress on Tuesday.

The difficulties in getting veterans timely care shows that, despite promises of fixes, department leaders are still struggling to streamline a multi-state system serving more than 550,000 veterans dealing with alcohol and drug abuse — about 8.5% of the total number of patients served by VA health care services. Lawmakers on the House Veterans’ Affairs Committee said they are hearing increasing complaints from veterans forced to wait for care in the VA system instead of being given options for care at private-sector facilities.

“Many veterans are trying to access care, but instead receiving delays,” said Jen Silva, chief program officer at Wounded Warrior Project. “Not finding appropriate care in a timely manner not only fails to capitalize on veterans’ desire to change their life circumstances, but in some cases causes further damage to their mental and physical health.”

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But department officials denied that the problems are a result of overbearing bureaucratic rules.

“We do not have a policy denying veterans community care access,” said Dr. Tamara Campbell, executive director of VA’s Office of Mental Health and Suicide Prevention.

Under current guidelines, VA health officials must provide “alternative treatment” to veterans seeking substance abuse treatment if they cannot find an inpatient bed within 30 days. That can include VA programs in farther-away cities or states, or private-sector health care options.

Officials from the VA Inspector General’s office said application of those rules are applied inconsistently, sometimes resulting in months-long delays. Veterans advocates testified about numerous calls from frustrated individuals who don’t understand what options are available to them, leading to waits of weeks or months for help.

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VA officials said they are working to speed up response times and available beds at department substance abuse centers. Officials have set a goal of hiring 1,100 new specialists to help with treatment programs this fiscal year, and have already brought in more than half of that total.

But lawmakers said they may need to pass legislation mandating more outside care referrals if administrators can’t find ways to streamline the current process. Veterans advocates pushed for dropping the current 30-day requirement to a week or less.

“Our country has been experiencing a substance abuse and overdose epidemic, and our nation’s veterans are not immune,” said Rep. Mariannette Miller-Meeks, R-Iowa and chairwoman of the veterans committee’s panel on health issues.

“One death from substance use disorder is too many, and it is a somber reality that many lives are taken by this treatable mental disorder.”

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VA officials said that in the last five years, alcohol abuse cases have increased about 5% among patients, amphetamine abuse has increased about 8%, and cannabis abuse has increased about 12%. Opioid abuse cases have remained steady over the same period.

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