As methadone replacement therapy (MRT) has been practiced in Taiwan for only two years, little is known regarding its effects. This case report introduces methadone withdrawal symptoms experienced by a heroin addict who used MRT for a period of four months. The author provided direct counseling and support to the patient as well as worked to empower colleagues and family members to support the patient's successful break with methadone. Discussions and suggestions relevant to MRT policies and the care of methadone users are provided at the end of this report.