With the increase of alcohol use and abuse in South Africa, there has been an increase in the frequency of drunken driving offences. The community has become increasingly irate at the horrendous damage and loss of life which are occasioned by these offences. The courts have therefore been forced to take not of public opinion, and the penalties have consequently become more stringent and punitive. This article focuses primarily on the recurrent conflict between medical treatment and the imposition of punishment when the court is confronted by a person who has been driving whilst exceeding the legal blood alcohol limit. The courts are faced with having to differentiate between those persons who have an alcohol dependency and those who have merely behaved irresponsibly. What do they do? If the law deals with both cases in the same manner, it would not be achieving anything. The legal system in South Africa needs to differentiate between those persons who have an addiction and subsequently need treatment, and those who need education. The legal system needs, therefore, to make provision for proper independent professional diagnostic assessment. This article suggests alternative options which the courts could adopt in order to deal with these offences in a more flexible and effective manner.