A needle exchange in Belfast will shut its doors on 2 November, because the charity running it is losing its city centre premises. Extern, the charity in question, will move to a "significantly reduced street-based service" after being evicted from its Royal Avenue location. The service, which let people who inject heroin or cocaine safely dispose of used needles, get clean ones, and access health services, is being described by its operators as "life-saving" - a phrase that, in this case, appears to be entirely literal.
"The people who use this service are someone's son, daughter, brother, sister, parent or friend," said Mal Byrne, Extern's director of harm reduction and mental health services. "They are members of our community, and, for many, this service is one of the few places where the door is open for them and where they can ask for help without judgement. That door is now closed until a space is secured to operate from." The charity also noted that the closure may make substance use more visible in the city centre, along with an increase in drug-related litter - because nothing says "public health solution" like swapping a support service for more discarded needles on the pavement.
The premises is being redeveloped as part of the Belfast Stories project. Extern has spent more than a year trying to find an alternative city centre site, with help from Belfast City Council, the Public Health Agency (PHA), the Department of Health, and landlords. So far, no luck. In addition to clean needles, the exchange offered wound-dressing services and advice on accessing temporary accommodation and healthcare. "Loss of a premises means people who need support to reduce harms from substance use have nowhere to go to access life-saving harm reduction advice and interventions, healthcare support and wider practical assistance," Byrne said. "This is a life-saving service. This work will be suspended."
The timing is less than ideal, given that cocaine use is believed to be on the rise in Belfast city centre. Extern estimates that between 1,000 and 1,500 people are experiencing difficulties with drug use at any one time. Last year alone, almost 20,000 used needles were safely returned by individuals who came to the Royal Avenue premises. Meanwhile, Extern's city centre outreach team removed more than 13,000 discarded needles from Belfast's streets - an increase of roughly 20% from previous years.
Independent councillor Paul McCusker warned the closure puts vulnerable people "at even greater risk" and has lobbied the council to explore alternative locations. "I am deeply concerned that any reduction in this service will have a devastating impact on the people who rely upon it," he said. "I have known individuals who have suffered life-changing consequences as a result of addiction, including the loss of limbs, and sadly, the loss of life itself. Belfast is currently in the midst of a drug epidemic, yet the political response has not reflected the scale of the crisis." McCusker, who founded a soup kitchen in north Belfast in 2017 and campaigns on homelessness, poverty, and addiction, added that over recent years there has been "a substantial increase in the number of people injecting drugs, which has led to an increased risk of blood-borne viruses, serious infections, abscesses, and addiction-related health complications."
He insisted that needle exchange services "play a vital role in reducing harm" and that the "fears and misconceptions" surrounding them must be challenged. "They provide an opportunity for drug support workers to engage with individuals, build trust, minimise health risks, and ensure that those who need help can be referred to appropriate treatment and support services."
The PHA commissions charities and participating pharmacies to deliver the Enhanced Needle and Syringe Exchange Service (NSES) across Northern Ireland. In 2024-2025, a total of 32,667 transactions were recorded by the NSES in Northern Ireland, an increase of 7.4% on the year before. About 721,000 needles and syringes were given out, a 7.5% increase compared with the previous year. The PHA said needle exchange sites "are located in areas where there is an existing pattern of injecting behaviour" and that "providing services locally is vital, as people who inject substances are often vulnerable, may be in poor health, can be dealing with complex social issues, and may be without local access to sterile equipment and advice. So support needs to be targeted in a way which maximises access. Needle exchanges are particularly valuable for engaging these people, because it may be the only service they are willing to use and provides opportunities to direct them to additional support and information."
In short: a service that returns 20,000 used needles a year and removes 13,000 from the streets is closing because its building is being turned into a storytelling project. One can only assume the story being told is a tragedy.