Hi!
I personally don't have to worry about these issues, though it may be worth bring up if you practice this kind of thing, once you're drunk, a lot of that fantasy/reality differentiation is thrown out the window, so you may as well not get into those kinds of things, and stick to the non-taboo.
You are actually addressing two important issues there.
First of all, being a responsible adult also means a responsible handling of legal drugs. Personally, I have no sympathy for someone who gets themselves drunk and then beat up people or do some other detestable thing. As an adult, you should know that alcohol removes inhibitions and you have to handle it accordingly.
Thus, I rather see this as an additional aspect those people with problematic fetishes have to be aware of and take into consideration. And if they every get intoxicated and act out the things they dreamed of in reality, at least in my eyes, it is just as if they did so deliberately. No one forces you to get drunk, you know.
Secondly, your post suggests an unfortunate misconception, so allow me to give you the facts as I know them: Real fetishes are not chosen by those who are into them. Whether they are the result of experiences or genetics, a fetish simply shows up in a person without them wishing for it or having any say in whether they have it or not. Whether fetishes can be removed seems unclear - there are some claims that they can be removed, and others who say it is impossible. But what can be achieved, of course, is schooling to control yourself. And that is the absolute minimum that should be expected of any fetishist: If you are not willing to control your urges, then you deserve whatever hardship society hands out to you.
Well, these are my thoughts on these issues.
Deathworks
EDIT: Clarified ambiguous formulation in second point.