Please read fully before responding. Here are some issues I have with the games balancing and maybe some changes that could be implemented.
I feel as though the game is too luck based and not enough puzzle focused. A lot of the fun you have with Buckshot Roulette is in the strategy in how you use your items to overcome the dealer. However, it's not fun to get guaranteed death after guaranteed death over and over with no way to win, even if you're using the most optimal strategy. I always end up dying by round 3-6 when going for the 1 million achievements due to unpreventable deaths. I got one run where I got to the final round and died again to a guaranteed death. I understand that luck is supposed to be a factor as this is a Russian Roulette inspired game, but making it the main factor over item strategy makes the game repetitive and annoying to play. I suggest balancing it to give the player at least some guaranteed alright items to start out with each round so you can at least have a better fighting chance when face with a dealer that has items to kill you in one turn. This makes the game more about using your brain to understand how you should use your items effectively, rather than praying for a god run where you get the items to kill him first round every time. Sure, the game does let you go first each round, but this doesn't outweigh the chances of you dying before being able to make that sweet crisp 1 Milly for the achievements.