The Extern-run needle exchange on Royal Avenue in Belfast city centre will close on 2 November, with a “significantly reduced street-based service” replacing it. The service allows people who inject heroin or cocaine to safely dispose of used needles, receive clean needles and access health services; it also provided a wound-dressing service. Extern described it as a “life-saving service” and warned its closure meant vulnerable people would have nowhere to go to access support.
The premises is being redeveloped as part of the Belfast Stories project. Extern has spent over a year searching for an alternative city centre location, a search assisted by Belfast City Council, the Public Health Agency (PHA), the Department of Health and landlords. No new site has been found.
"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."
Byrne warned that the loss of a premises means people seeking to reduce harms from substance use have nowhere to go for life-saving harm reduction advice, healthcare support and practical assistance. "This is a life-saving service. This work will be suspended," he said.
Extern also cautioned that substance use may become more visible in the city centre and drug-related litter could increase. The closure comes amid what Extern believes is a rise in cocaine use in Belfast city centre. The charity suspects that between 1,000 and 1,500 people are experiencing difficulties with drug use at any one time.
Last year, almost 20,000 used needles were safely returned to the Royal Avenue premises. Extern's city centre outreach team removed more than 13,000 discarded needles from the streets, an increase of roughly 20% from previous years.
A service user said they had built a bond with workers at the exchange. "Over the last number of years, I've built up a bond with a couple of the workers," they said, adding that there are days they go in "feeling very low, not going in to use equipment, but just to go in to get a chat". They described the staff as "like family" and said the closure "will have a big impact with our mental health".
Independent councillor Paul McCusker warned the closure puts vulnerable people "at even greater risk". He 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. "Belfast is currently in the midst of a drug epidemic, yet the political response has not reflected the scale of the crisis." He said needle exchange services "play a vital role in reducing harm" and misconceptions about them must be challenged.
The PHA commissions the Enhanced Needle and Syringe Exchange Service (NSES) across Northern Ireland. In 2024-2025, 32,667 transactions were recorded, a 7.4% increase on the previous year, and about 721,000 needles and syringes were given out, a 7.5% increase. The PHA said needle exchange sites are located in areas where there is an existing pattern of injecting behaviour, and providing services locally is vital. "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," the agency said.
Analysis
Why This Matters
- The closure removes a key access point for harm reduction services for people who inject drugs, increasing the risk of blood-borne viruses, infections and overdose.
- The reduced street service may be unable to match the volume of needle returns and engagement the city centre premises provided.
- The loss of the site is expected to make drug use more visible in the city centre and potentially increase drug-related litter.
Background
Needle exchanges are harm reduction services that provide sterile injecting equipment and safe disposal to reduce the transmission of HIV, hepatitis C and other infections, and to encourage users to access health and social support. The Extern exchange had operated from Royal Avenue in Belfast city centre and is closing because the building is being redeveloped as part of the Belfast Stories project. The charity spent more than a year trying to find an alternative city centre site with support from the council, the health department and landlords, but no premises was secured.
Key Perspectives
- Extern: describes the needle exchange as a "life-saving service" and says its closure leaves vulnerable people with nowhere to turn for harm reduction advice, healthcare and practical support. The charity warns that substance use and drug-related litter may become more visible in the city centre.
- Independent councillor Paul McCusker: says the closure puts vulnerable people at greater risk; he criticises the political response to what he calls a drug epidemic and has lobbied the council to find alternative locations.
- A service user: says the exchange provided more than needles, a place to chat and feel supported, and that the closure will have a significant impact on their mental health.
- Public Health Agency: says needle exchange sites are located in areas of existing injecting behaviour and are valuable for engaging people who may otherwise not access help.
What to Watch
- The date of closure on 2 November and whether the replacement street-based service can sustain engagement with service users.
- Whether efforts to secure a new city centre premises resume, led by the council and health agencies.
- Potential public health indicators in the following months, including discarded needle counts, overdose reports and infection rates.
Checked
11 claims in this story checked against 1 source: 11 supported.
Show each claim
- SupportedThe Royal Avenue needle exchange will close on 2 November and be replaced by a significantly reduced street-based service.BBC Northern Ireland: “The service will shut on 2 November and move to a "significantly reduced street-based service" following the loss of Extern's Royal Avenue premises.”
- SupportedExtern says vulnerable service users will be left without access to life-saving harm reduction support.BBC Northern Ireland: “The charity described the needle exchange as a "life-saving service" and warned that its closure meant vulnerable people would have "nowhere to go" to access support.”
- SupportedMal Byrne said: “The people who use this service are someone's son, daughter, brother, sister, parent or friend. 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.”BBC Northern Ireland: “"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."”
- SupportedExtern suspects between 1,000 and 1,500 people are experiencing difficulties with drug use at any one time.BBC Northern Ireland: “"We suspect that there are between 1,000 and 1,500 people at any one-time experiencing difficulties with their drug use," the charity said.”
- SupportedExtern said almost 20,000 used needles were safely returned to the Royal Avenue premises last year.BBC Northern Ireland: “"Last year alone, almost 20,000 used needles were safely returned by individuals who came to the premises on Royal Avenue," it added.”
- SupportedExtern’s city centre outreach team removed more than 13,000 discarded needles from Belfast’s streets.BBC Northern Ireland: “"Extern's city centre outreach team removed more than 13,000 discarded needles from Belfast's streets.”
- SupportedExtern said the number of discarded needles removed was roughly 20% higher than in previous years.BBC Northern Ireland: “"This is an increase of roughly 20% from previous years."”
- SupportedA service user said: “Over the last number of years, I've built up a bond with a couple of the workers.”BBC Northern Ireland: “"Over the last number of years, I've built up a bond with a couple of the workers," they said.”
- SupportedPaul McCusker warned the closure puts vulnerable people “at even greater risk”.BBC Northern Ireland: “Independent councillor Paul McCusker warned the closure puts vulnerable people "at even greater risk"”
- SupportedThe NSES recorded 32,667 transactions in 2024–2025, a 7.4% increase on the previous year.BBC 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.”
- SupportedAbout 721,000 needles and syringes were given out in 2024–2025, a 7.5% increase on the previous year.BBC Northern Ireland: “About 721,000 needles and syringes were given out, which is a 7.5% increase compared with the previous year.”
