I think it was Chima who said somewhere that while Dustin drinks a lot, he manages to keep a fairly organized life. There are a bunch of highly successful people who are functional alcoholics, although, that doesn't stop the health risks.
Now, maybe Dollin is one of those guys and most of the Piss Drunks/Baker aren't. It clearly fucked with their ability to keep an organized life and led to a bunch of issues or eventually they just got over it. But, from the stories it seriously fucked with Reynolds life, brought Greco and Heyl down a further patch of addiction, got Ali put in jail, and in the case of some of the younger generation of people affiliated with Baker, it fucked with Spanky and Braydon's abilities to keep up the obligations to there sponsors and remain productive thereby killing their income stream.
Say what you want about Dollin, but he hasn't found himself in serious trouble that we know of, the guy pumped out footage for 15 years with his knees being his primary issues and has maintained his primary sponsors for almost 2 decades (Vans, Volcolm and Baker).