Early laws simply prohibited driving while intoxicated, with no specific definition of what level of inebriation qualified. The first generally-accepted legal limit for blood alcohol concentration (BAC) was 1.50.

In the US, most of the laws and penalties were greatly enhanced starting in the late 1970s, and through the 1990s, largely due to pressure from groups like Mothers Against Drunk Driving (MADD) and Students Against Driving Drunk (SADD) and leaders like Candy Lightner. These organizations — MADD in particular — are also widely cited for getting the drinking age raised to 21 in those states where it had once been lower. Also during this era, enforcement of drunk driving laws became a priority for police for the first time.