The application of opioids in the proximity of the spinal cord is a recent addition to the forms of treatment available for pain relief. During the last 20 years we have learned more about the intimate mechanisms of the action of opiates then we had in the preceding 5 millennia. Opium, in fact, has been used for medical purposes from prehistoric times. On the basis of the newly acquired knowledge, we are now applying opioids in more effective ways and providing more patients with long overdue relief of their pain.