Many perks have some inconveniences:
-all perks affecting stats (like ken, juggler, brute etc…) will cap some stats below 20
-ascetic (once hungry the debuff is higher)
-contemplative (can’t sleep off/wait off overeating)
-heavy swing (will consume more stamina per strike, makes you more vulnerable to melee damage, because melee hits deplete stamina first)
-light striker (your hits with one handed swords are faster but weaker)
-tin opener/ weapon cruncher (armor/arms used by enemies deteriorate faster, so they lose some effectiveness and a lot of value, they’re also more expensive to repair if you want to keep them
-sprinter/marathon runner (one makes you run a bit faster for a bit shorter range, the other does the opposite)
-dreadful (enemies are more likely to run away, along with most of the loot)
-boar (increases the chances of causing health damage when running into someone, unless you pay attention riding a horse around people you’ll probably trample a few civilians to death and get jail time)
-local hero/villain (one will make it harder to increase your reputation but give you greater benefits for high reputation, the other will make the opposite)
-sword perks (while not exclusive, you won’t get enough points to earn them all, so chosing one locks you out from others, also some can’t be performed without a free off hand).
Many perks have downsides, so they’re more like character traits in Fallout (albeit earned) - make your character more specialized, not necessarily better or worse. Drinking perks give you the choice to customize your character in several ways, you can take the beer/wine biber to endure smaller or larger amounts of booze by simply choosing what you drink at a given moment, you can be that person who never passes out, or the one who never suffers any penalties from passing out.
The drinking skill tree is imo the most useless one, only good for immersion. Unless you save with Saviour Schnapps or drink with Godwin, you can complete the game without ever tasting alcohol.