Addiction treatment centers are struggling to find enough qualified personnel as the opioid crisis worsens, The Wall Street Journal reports.

Retention of addiction treatment workers has long been an issue because of low pay, high burnout rate and the stigma attached to addiction, the article notes. Many counselors move on to other fields after several years.

There are many reasons the demand for addiction treatment workers—including psychiatrists, licensed counselors and house aides—is increasing. The number of patients addicted to heroin and prescription painkillers is on the rise. The Affordable Care Act requires private insurance companies and Medicaid to cover substance use disorders, and states that have expanded Medicaid under the law have made coverage available to many new patients. In addition, a growing number of localities are steering drug offenders to treatment instead of prison.

“Our biggest problem right now is a lack of workforce,” said Becky Vaughn, Vice President of Addictions at the National Council for Behavioral Health, which represents addiction-treatment providers. “We’re ready to expand, we have new opportunities and new funding sources. But it’s all sort of moot if we don’t have the people to provide the care.”

The U.S. Bureau of Labor Statistics estimates the number of jobs for addiction and behavioral-disorder counselors will rise 22 percent, from 94,900 to 116,200, between 2014 and 2024. In contrast, the number of jobs overall in the United States is expected to grow 6.5 percent during that period.

“The educational pipelines can’t produce that number of people that quickly,” said Jeff Zornitsky, Director of Strategic Initiatives at the health consulting firm Advocates for Human Potential.

The federal government has launched programs to address the shortage. Some programs increase addiction training for existing professionals in nursing, social work and other fields. Others aim to recruit workers to the behavioral health field as early as high school.