I'm planning on running HHM as apart of the ROTRL adventure path next week (They just finished an overly complicated Skinsaw Murders session) and after reading the next adventure I have only this to say;
No DM worth his flawed d20`s cant make HHM as R-rated as he wants it to be. I plan on altering a few thing to give the players the true disturbing feel they should receive from dealing with such a horrid gang as the grauls. Honestly, Mr.Louge did a fantastic job bringing the adventure, but as we all know, it`s the DMs job to make it fit our group. As perverese as that job might be.
Oh yeah, props for the mature content only, there is a market for it.