The deck is a great toy, but you have to realize its limitations, prepare the players, and never, ever let it be an unknown. The characters should always be aware that it exists and it should have a reputation in game just as bad as it does in real life.

You tell the players ahead of any possible pull that it’s optional, that some of the effects are ruinous to a character, and that there’s no take backs. Make very certain that they know that the odds are only slightly better than Russian roulette, and that the outcome can be just as drastic for their characters.

If you aren’t willing to put that kind of effort into them gambling in a way that can fuck up the campaign/adventure/world you’re running, then don’t use it at all.

You can nerf the deck instead, changing or removing the extremes. But that takes the “fun” out of it. And there are people that love the rng craziness of it.

If it’s done right it is fun. But it’s so easy to do it wrong that it isn’t usually worth it when you can get similar results with good storytelling