ATLANTIC CITY — Inside Jogi Discount Pharmacy on Atlantic Avenue, manager Rakesh Kundalia scans his computer screen for the number of Narcan prescriptions the store has filled in the past month.
“It’s usually four or five,” he said, a small, blue naloxone kit — the generic name for the opioid antidote — sitting beside his keyboard. “We fill many more narcotics prescriptions.”
The family-owned store is in downtown Atlantic City, a resort of 38,000 hit hard by the opioid epidemic, where police removed almost 33,000 individual doses of heroin from the streets last year.
At Jogi Pharmacy, patients can buy Narcan with a prescription.
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But a recent Rutgers study found the lifesaving drug was not as widely available in pharmacies in poor, large New Jersey cities facing the brunt of the nationwide crisis as it was in smaller, wealthier towns.
In New Jersey, drugstores have been allowed to dispense naloxone over the counter without requiring a prescription since 2017.
In Atlantic City, about 16% of the city’s pharmacies carry naloxone, the study found. The median household income for residents is $26,500.
Compare that to Readington, a township in Hunterdon County with a median household income of $125,700, where 66 percent of pharmacies carried the drug, according to the report.
The study’s results come from a survey of 90 pharmacies in 10 New Jersey cities between February and July 2017, before legislation passed allowing all pharmacies in the state to dispense Narcan.
“The results suggest an unsurprising and concerning pattern: Patients living in the most populous poorer areas are also living in areas with less access to naloxone,” according to the study, which was published in the Journal of Medical Toxicology.
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Cities with severe opioid-related public heath concerns that had limited naloxone access in pharmacies included Newark, Camden and Atlantic City, which researchers dubbed “Narcan deserts.”
One reason, they conclude, could be the high cost of purchasing the drug without insurance. Narcan nasal spray can range from $70 to $300. At Jogi Pharmacy, two doses cost about $130, Kundalia said.
“Naloxone is covered by Medicaid in New Jersey, which would help reduce this price barrier, but unfortunately many patients lack health insurance,” the report states.
Pharmacies aren’t the only place to get naloxone, though.
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Atlantic City police officers have been carrying naloxone since 2015 and have deployed the drug 64 times in four years, according to the department’s End of Year Report. Sargent Kevin Fair said it's only used in the event someone is overdosing, and not given out outside of emergency situations.
The South Jersey Aids Alliance on Tennessee Avenue also gives free Narcan kits to people who participate in its syringe access program. The nonprofit has received more than 80 reports of naloxone being used since it started giving out the drug in 2014, according to CEO Carol Harney.
Still, access could be better, said Diane Calello, executive and medical director for the New Jersey Poison Information and Education System and one of the Rutgers study’s authors.
Calello said there’s a lack of easy-to-find and reliable information for nonpharmacy naloxone distribution programs in New Jersey but did not specify Atlantic City.
“Anytime you’re dealing with a burden or illness ... the fewer hurdles to getting what you need, the more likely you are to take care of yourself,” Calello said. “Getting your prescription and having to take it to the pharmacy is not hard, but it’s just another step.”