Lewiston officials have again put off voting on an ordinance regulating needle exchange programs in the city, but a majority of councilors agree that a controversial limit on how many clean needles providers can hand out should be removed.

The discussion Tuesday was the latest in the city’s monthslong debate over how to regulate needle exchange programs in response to concerns from businesses and residents over rising needle waste and disruptive behavior.

However, officials have struggled to find a consensus on several pieces of the proposed ordinance, including how syringe service programs handle the exchange of dirty needles for clean ones, and where such programs can be located.

Councilors also questioned the urgency of the ordinance now that the Church of Safe Injection, which was arguably the target of much of the ordinance language, has had its license to operate revoked by the state after the building it rents was condemned.

Council President David Chittim, who presented the council with a long list of amendments Tuesday, made a motion to remove any reference to a 1-to-1 exchange, which councilors ultimately supported by a 4-3 vote.

While some councilors have argued that limiting providers to a 1-to-1 exchange would help address needle waste, public health professionals across Maine have said the move would increase the risk of spreading blood-borne diseases and hamstring providers’ ability to be flexible with patients.

“Limiting to 1-to-1 is uncalled for, particularly after the actor who occasioned this ordinance is no longer a character in the drama,” Chittim said, referring to the Church of Safe Injection. “Now it’s just a bunch of laypeople on the council contravening what has been a flood of best practices and medical evidence indicating that multiple needles are needed for harm reduction.”

The debate over the exchange ratio stems from a 2022 change that allows syringe service providers to give out as many as 100 needles for every dirty needle received.

Gordon Smith, director of opioid response for Gov. Mills’ administration, asked Lewiston officials to “stay the course” on the 1-to-1 issue, especially as the number of overdose deaths continues to decline.

He and other health professionals have said the change was made because fentanyl has a low life, meaning those addicted are often using 10 needles a day, and needles should only be used once before the risk of infection increases.

Councilor Eryn Soule-Leclair, who has supported regulations on needle exchanges, questioned whether it’s been the expanded needle exchange ratio or more broad use of Narcan that’s causing the decline in overdose deaths.

She said despite having three needle exchange programs, Bangor has had 27 cases of HIV, “so I don’t see how the one-for-100 is helping anyone.”

“All the accountability is being put on the residents of Lewiston,” she said. “We need more accountability.”

During public comment, former public health nurse Ronnie Paradis said officials “need to care about the other people in Lewiston, not just substance abusers.”

“You don’t listen to the boots on the ground, you listen to the top, who have never been out on the streets of Lewiston,” she said.

Councilor Tim Gallant said he’d like to see a more nuanced approach, with clients receiving a maximum of 10 needles a day, and 25 on Friday for the weekend.

Gallant, who lost a son to an overdose, said, “We’re wrapped around needle waste and not wrapped up around saving individuals.” He argued that not having a limit on needles means less contact with clients.

“We might as well go out and put needle dispensers around,” he said.

Councilor Scott Harriman said that while the ordinance stemmed from councilor concerns over needle waste, the ordinance “doesn’t address litter in any way.”

He said business licenses are already approved by the council, while other provisions in the ordinance will make contact with clients more difficult for providers. Harriman suggested the city use opioid settlement funds to install more sharps containers and conduct more needle cleanups.

With the Church of Safe Injection closed, Lewiston’s only remaining provider is Spurwink on outer Lisbon Street, which has received support from the council.

Catherine Ryder, senior director of strategic initiatives for Spurwink, said she believes the decrease in deaths in Lewiston is “a direct result of harm reduction efforts.”

Ryder said over the past two months — likely related to the Church of Safe Injection’s closure — Spurwink has seen 200 new clients. She said under a 1-to-1 model, that would have meant “a lot of people who would be walking out without clean needles.”

She said clients have different needs and “we want to be able to customize and be flexible.”

Councilors also debated zoning and other elements of the ordinance language, but ultimately decided to table the discussion until the Oct. 7 meeting.