Rating issues
This arcade-style game offers a top-down perspective with characters appearing as small graphical representations of demons, flies and other human-like enemies. Representative blood fx are visible, but the illustrative style is somewhat unrealistic and indistinguishable as ‘real’ people. Isaac employs a blob-like weapon and bombs to destroy his enemies and gains power ups and extra lives as he progresses through a series of rooms.
Other issues
The game also depicts the main character using a syringe containing ‘Speed Ball’ in order to increase his speed and rate of fire. ‘Speed Ball’ is a known illegal drug in the UK containing a mixture of cocaine and heroin/morphine.