Attitudes about drinking and driving have changed dramatically over the past few decades due to a combination of factors. Initiatives to address impaired driving have varied from harsher penalties to substance abuse treatment responses. This article reviews what works, what doesn't, what is inconclusive, and what looks promising for the future including traditional police responses such as sobriety checkpoints and vehicle or license sanctions. Victim Impact Panels and other more innovative initiatives have mixed reviews. Knowing that severity of sentences does not affect long term change, the criminal justice system has initiated robust programs that look promising. Courts are using new technologies and pharmacological responses to monitor offenders and reduce recidivism. Over the past ten years, Driving While Impaired (DWI) courts have sprung up throughout the United States and look to be an important part of the goal of reduced impaired driving and resulting crashes.