The series is never frightening, but is often shocking, particularly the climax of season 2, episode 11, which is very disturbing and alarming. All shocking scene are; however, infrequent and over with fairly quickly.
A character vomits a copious amount of blood, due to severe illness brought on by liver damage
A toddler accidently ingests cocaine the was left lying on a counter during a party (not shown)
A teenage character gives birth to a baby with Down's syndrome, whom she rejects, abandons, and calls the "R" word several times.
A lot of shock value scenes in which a lot of the characters, commit petty theft crimes, sell drugs from an ice cream truck, break into houses, buy guns from an illegal arms dealer, run a massage parlor from a local bar.
A couple having difficulty with conceiving a baby, utilize the woman's mother as a surrogate, with the man having sex with the mother, which results in pregnancy.
After a woman learns she is pregnant with multiples, she insists that the surrogate carrying her husband's child, have an abortion when the surrogate is already several months along, and has a non chalant attitude about it.
Season 4 in particular is very emotional and distressing.
Total Explicit Content: 41/50.
Showtime's official rating for the series: TV-MA (LDSV): Graphic Language, Adult Content, Sexual Content, Nudity, Mild Violence
Suggested MPAA Rating: Rated R for substance abuse, pervasive language, strong sexual content including graphic nudity, and violence - some involving children.