Buckshot Roulette is a brilliant, if flawed, little experience.
I believe that items too often can be distributed in a way that makes the game very one-sided depending on who gets the lucky draw, while there are a host of available solutions such as item distribution being more controlled and less random or simply removing/rebalancing certain items these could completely change the player experience in unintended ways and as such I understand why the game hasn't seen any major rebalancing since launch (aside from the changes added in the 1.2.2).
Ultimately it succeeds in immersing the player in it's world and it's gameloop is simple but effective. If you want the full package I recommend buying the game on Steam as multiplayer is good with friends.