VA under fire over substance abuse treatment wait times

Lawmakers and advocates pressed the Veterans Health Administration (VHA)on Tuesday over long wait times for veterans seeking treatment for substance use disorder, especially due to the particularly high suicide risk within the population. 

“We can figure out that paperwork later,” Thomas Sauer, chief executive of Miramar Health, told a hearing of the House Committee on Veterans Affairs’ health subcommittee. “The current VA policy of 30 days to wait to find a bed in a given region does not meet the urgent level of this crisis.”

Daniel Elkins, chief of staff at The Independence Fund, an organization that supports the mental and physical independence of veterans, echoed Sauer’s call. 

“In a 30-day period, the risk of suicide or destabilization can drastically increase, so we recommend a clinically sound lesser number of days because PTSD, in conjunction with SUD [substance use disorder], requires swift intervention and services,” he said. 

Between 2001 and 2020, the prevalence of substance use disorder diagnoses among the VHA’s “recent veteran users” rose from 27.9 percent to 41.9 percent, the VA reported in its 2022 annual suicide prevention report. 

The overall suicide rate among that group fell by 28.7 percent over that same period; however, they were still almost twice as likely as non-users to commit suicide. 

Rep. Julia Brownley (D-Calif.), the subcommittee’s ranking member, said there was a clear disconnect between the need and access to substance abuse care. 

“What I’m hearing from the panel, too, as well, is that the quality of care within the VA, once a veteran gets into the VA, is very good,” she said. “So I think, you know, clearly something has to be done here around these access points.” 

Research by the VA showed in 2017 that substance use disorder “sharply increased” the risk of suicide for veterans. Of 4.8 million veterans studied, 8 percent of men and 3 percent of women had “problems with drugs or alcohol.” 

And almost 20 percent of veterans returning from Iraq or Afghanistan as of 2019 suffered from PTSD, depression, or traumatic brain injury, which predispose individuals to substance abuse, according to the VA.

“I’m saddened and I’m frustrated that this is how VA has been managing care for those who have selflessly served our country,” said Rep. Mariannette Miller-Meeks (R-Iowa), who chairs the subcommittee. 

“The most important metric of success is whether the suicide rate has gone down, and unfortunately, it has gone up,” Miller-Meeks said. “No veteran should be turned away when a decision is made to seek health.”

Brownley noted the challenge “was only compounded by the COVID-19 pandemic, which increased feelings of social isolation, anxiety, and depression and caused many adults to start or increase their use of alcohol or drugs.” 

Tamara Campbell, executive director of the VHA’s Office of Mental Health and Suicide Prevention, assured lawmakers that a “full comprehensive continuum of care” was available to veterans, from outpatient telehealth to inpatient treatment.