Serve over crushed ice. The freshly grated nutmeg is essential. When bareboating, we use plastic gallon water jugs to make them, which works out to about a bottle of rum, a BIG can (46 oz.) of pineapple juice, one small (12 oz.) can of OJ, and 1 large (12 oz.) can of Coco-Lopez. This mixes up just under a gallon. Remember, there really is no substitute for Pusser's rum in a painkiller.
This, like other island drinks is properly served only in a disposable plastic cup.
If you like Painkillers, then you might also want to try our Painkiller Cake recipe.