Veterans who take narcotic painkillers are struggling to get monthly appointments at Veterans Affairs (VA) health facilities to renew their prescriptions, as required by new federal rules.

The Washington Post reports restrictions adopted by the Drug Enforcement Administration (DEA) last summer require veterans to return to their doctor monthly for opioid prescription renewals, even though it was already difficult to get appointments at VA facilities. Veterans who live far from VA health centers face additional hardships in getting to their appointments, the article notes.

The DEA restrictions are designed to reduce opioid abuse. The rules apply to all patients taking opioid painkillers, but they are particularly burdensome for veterans, according to the newspaper. Many veterans are being treated for extensive injuries they received in the wars in Iraq and Afghanistan. More than 500,000 veterans are currently being treated with prescription opioids, according to the VA.

The VA has set up a Choice Card program, which allows veterans facing long waits for appointments, or who live far away from VA facilities, to use a private clinic instead. Veterans say the program is confusing and complicated.

A 2013 report by the Center for Investigative Reporting found the death rate from opiate overdoses among VA patients was almost double the national average. Prescriptions for hydrocodone, oxycodone, methadone and morphine jumped 270 percent in the past 12 years among VA patients, the report found.

A study published in 2012 found veterans with post-traumatic stress disorder were more than twice as likely to receive opiates compared with veterans without mental health problems. These patients are at greater risk of overdose and suicide.