Should Denver allow more needle exchange programs? Some council members — and the mayor — aren’t sure.

Denver would eliminate its limit on the number of needle exchange programs that can operate in the city and remove restrictions on their location under a new ordinance set for a final vote Monday.

The city allows only three programs currently, but if the City Council adopts the new rules, an unlimited number of sites could open in areas zoned for medical offices. The change would also remove existing buffers, allowing needle exchange sites to open within 1,000 feet of schools and day cares.

Needle exchanges, also known as syringe access programs, provide services to drug users including clean needles, education, and access to mental health and addiction treatments. The Centers for Disease Control and Prevention recommends them as a way to prevent the spread of diseases like HIV and hepatitis, while reducing the impacts of drug use on a community.

Last week, eight of the 12 council members present gave initial approval to the proposed changes, and four voted against the measure. Council President Amanda Sandoval was absent.

Supporters say the expansion could help blunt rising overdoses in Denver, pointing to data that show drug users who visit needle exchange programs are much more likely to seek treatment than those who don’t. Denver has seen a sharp increase in accidental overdose deaths in recent years — more than doubling from 199 in 2019 to 553 in 2023.

“We are looking for ways to save lives in this crisis. This is it,” at-large Councilwoman Sarah Parady said during a December committee hearing about the ordinance.

Some needle exchange programs offer clean smoking pipes, testing strips and overdose reversal drugs. Sites also allow disposal of used needles so that they don’t end up being reused or dropped on the ground.

The proposal pits the council’s farther-left progressives against its more moderate members, with some falling in the middle of those two groups. The initial vote’s margin was tight enough to prompt speculation about whether the mayor, who has voiced concerns but stopped short of threatening a veto, will try to stop the changes.

Opponents on the council say they would support expanding the program only if some restrictions remain in place to limit negative impacts on neighbors of the facilities.

“This isn’t a conversation about if harm reduction works — this is a changing of these particular rules,” Councilwoman Flor Alvidrez said in the committee meeting.

Alvidrez, along with Kevin Flynn, Amanda Sawyer and Diana Romero Campbell, voted against the ordinance on Jan. 6.

Sawyer, who represents District 5 in east Denver, said she was opposed because of negative experiences she heard about from residents who lived near a previous location of one center. The two needle exchange programs with fixed locations are now in central Denver.

“I can tell you that the in-person needle exchange program is a terrible neighbor,” she said at the meeting last month.

The proposed changes would require the centers to enter into “good neighbor agreements” with surrounding communities to outline their expectations. While those agreements were initially nonbinding, the sponsors decided to make them part of the sites’ licensing requirements after several council members expressed interest in having a process for shuttering centers that don’t meet certain standards.

Sawyer suggested that she would support the ordinance if the council instead allowed for more programs by adding only health care providers, like hospitals and urgent care centers, to the list of permissible operators. The sponsors of the legislation — Parady, Serena Gonzales-Gutierrez and Stacie Gilmore — rejected the idea, saying it would be too limiting and many drug users don’t trust health care centers.

“These things that are being proposed aren’t going to address the need for access to these programs,” Gonzales-Gutierrez, an at-large member, said in an interview.

She added that the proposal was in line with recommendations from the city health department, which has listed the restrictions as a “significant barrier” in its work.

Flynn said he favored raising the cap on programs but was concerned about getting rid of the distance requirements for schools and day cares because of the potential for supervised drug-use sites to open in those locations someday. Flynn, who represents southwest District 2, cast the sole dissenting vote on a 2018 ordinance allowing the sites, which allow people to use illicit drugs while being monitored by medical providers, helping to prevent or respond to overdoses.

The city doesn’t have any supervised-use sites open, however, because of state-level prohibitions.

“God forbid a future legislature authorizes Denver to enact that ordinance,” he said. “Then I would have prospectively allowed a supervised drug-use site to open up next to a school. And I can’t live with that.”

Flynn also said he was dissuaded from supporting the needle exchange changes by a comment Parady made during the committee hearing about reducing stigma. Parady said she wanted the council to convey to drug users that help is available and that “we think it’s fine for school kids and their parents to see drug users — they are part of our community.”

A statement from Mayor Mike Johnston’s spokesperson, Jordan Fuja, suggested he was also skeptical of the proposal.

“We believe there is an adequate supply of needle exchange programs to meet the current demands,” the statement says. “We will continue to focus our efforts on increasing access to the desperately needed in-patient and out-patient treatment options that help people recover.”