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Alcohol-related collisions cause numerous deaths and injuries. The purpose of this paper is to review the technological changes that could be made and are being made that could reduce rates of impaired driving collisions. These can be classified into four categories: 1) interlock systems based on testing drivers’ blood alcohol concentration, 2) systems for monitoring driver behaviors such as head and eye or pupil movements, 3) systems that monitor vehicle dynamics and behavior, and 4) remote detection and stopping vehicles technologies. Each of these technologies has some efficiency and uses and varying levels of social and individual acceptance. Innovation may come from looking at novel ways of combining these technological designs to achieve targets to reduce the devastating effects of impaired driving for many communities.