They get what is known as an "Occupational License". As parent noted for almost all of the US if you don't have a car you cannot participate in the economy. You

They get what is known as an "Occupational License". As parent noted for almost all of the US if you don't have a car you cannot participate in the economy. You can't get anywhere to work and you can't get anywhere to shop. You can't get healthcare. You basically can't do anything. Drunk driving penalties in almost all states include a minimum six-month license suspension. However, if that were universal it would completely destroy lives and have massive downstream effects. The Occupational License is an (on paper) license solely limited to driving between specifically classified types of places - work, church, healthcare, basic shopping, school, some stuff for your children, etc. Not only is it not a license to drive drunk, many of them have the added condition that the vehicle needs an "ignition interlock" device (paid for by the driver) that requires a breath sample before the car will move. Many of them also have functionality where you need to periodically blow into it while driving before the device shuts the engine down. Of course enforcement here is an issue. Many people drive with completely suspended/revoked licenses, no insurance, etc and get away with it everyday. However, many police departments deploy either stationary ALPRs (automatic license plate readers) or have them installed on police vehicles. They're creepy but amazing - I was on a "ride along" with the police once and we'd be driving down the road at 45 mph. It would sound an alarm and have a synthesized voice that says something like "Florida license XYZ - suspended". The cop would just turn the car around and pull the person over.