Hell's Wheels medal does indeed appear to be broken, as @blyndid writes in his review and in my own testing.
What *should* award it is any of the following (among other possible combinations)
1 drug and 3rd death on precisely 660
10 drugs and 3rd death on precisely 606
100 drugs and 3rd death on precisely 333
I've tested the 1st and 3rd of those (actually did the 3rd first, and when that didn't work, tried with EXACTLY 1). Refreshed and retried several times. No medal awarded.
It's hard enough to do I'm not even sure who all (other than myself and @blyndid) can even verify this one. Many times hitting on final score of 665 or 667 as I was 1 off and you do have to get it EXACTLY.
Also you're wrong @HerbieG in saying the game has no skill. The game is mostly skill, although there is also a luck component. But this exact one medal appears to be broken, unless someone else with the skills can make it work for them. Didn't work for me or @blyndid.