Any method you use can be broken. Your only chance is to reduce the likelihood that your site is worth the effort.
Basically, if you use a common solution - no matter of FOSS or commercial - then there will be a thousand other sites that use it too. This attracts attackers because they know when they hack it once, they can re-use it.
However, if you handcode something, no matter how primitive, it likely lasts a lot longer because nobody bothers hacking into your site...
Of course that doesn't work if you have a large site like myspace - there, a single site is worth the effort by itself.
Anyway - then there are two things - a really fast moving animated gif and silly things where you ask people to identify items usually work.
I help out with a site that randomly takes five pictures of cats and dogs and it asks you to identify which of the images contains the highest number of kittens... We barely ever get spam through - and that with almost 20K attempted submissions by non-humans a day makes us pretty happy
Peter.