From one third to one half of all traffic fatalities in developed countries involve alcohol. Strategies to reduce public risk in the past 25 years include license suspension, alcohol treatment, vehicle impoundment, special letters on tags, and probation monitoring. The first alcohol ignition interlock program began in California in 1987. The interlock requires the driver to provide a breath sample that has low or no alcohol before the engine will start. Courts and motor vehicle agencies are using the interlock as a bridge to relicensing for offenders convicted of driving under the influence. More than two-thirds of the states and parts of Canada and Australia now have a program or law authorizing the interlock. If offenders are assigned an interlock as the intermediate step between suspension and reinstatement, and if a case manager can be assigned to help link the offender to helpful services, a new bridge across the division between health and crime can be achieved. Consultation with a case manager would improve identification of needed services and an opportunity to reduce harm by building in coping skills for relapse prevention. 41 references (Author abstract modified)