There is one scene where a couple attempt to have kinky sex near the lake with the woman's bare breasts are seen. She tries to penetrate his rear with a sex toy but is interrupted by the killer.

A man is stabbed in the back with a meat cleaver and his spine is torn out through the cut. This is really GRAPHIC AND VERY SICKENING TO WATCH!

A pregnant woman has her stomach sliced open, and her infant removed.

There is some uses of f*&k, s%$t, and other profanity sprinkled throughout. A band called the Royal C%@Ts is mentioned twice.

Some characters smoke cigarettes in a few scenes.