a) a typo can run unintended code on your box
b) a bad/old/hacked project (correctly typed) can run unintended code on your box
c) both of the above conditions are considerably more severe because they can be triggered with near-zero friction (unlike a gemfile, which are manually pulled-down and code is run from a separate command. Gemfile results are also generally small enough (1-2 pages) that one can visually spot typos if you are monitoring the output
d) complex dependency systems can often turn into dependency hell
e) (IMHO) instantly-available dependencies potentially reduce a given programmer's likelihood to attempt to solve their problems with the language itself (i.e. don't use Cassandra when a Dictionary will do) ... the nodejs community seems especially susceptible to this
That's all I can think of right now...
However, I'm not sure I agree with the statement - you could use this tool and still have the discipline not to pull in random packages.
If there is a friction, the balance is changed a little against pulling dependencies, at least those most trivial.