Fallout 4's release date is fast approaching, and the ESRB has checked in with Bethesda's latest release to give their rating for the title as is customary. It will be rated M for Mature, like all the other games in the series, listing "Blood and Gore, Intense Violence, Strong Language, Use of Drugs" as the reasons. Nothing seems concerning there, until you go back and look at Fallout 3's description. They are similar lists, except that Fallout 3 had "Sexual Themes" attached, where Fallout 4 does not.
When looking at the more detailed descriptions, we see that they read very similar, except Fallout 3 features a passage about prostitutes that appeared in the game. A similar passage can also be found in the rating description for New Vegas. Anyone who has played the modern Fallout games will tell you that these characters were not a huge part of the experience in any way, only really factoring into a few side quests. Still, they have been in the series since the beginning, including Fallout 2's New Reno area and even a minor character in the unpopular Xbox spin-off Brotherhood of Steel.
The only other difference in the two descriptions is the way that the ESRB describes the player consuming fictional drugs like Jet and Mentats. Fallout 3's description mentions that the player can not be seen consuming those drugs, but Fallout 4 just states that the player is using them. Whether this means that the player will have an animation for using those drugs like Bioshock's plasmid injections is yet to be seen. Considering that they're adding to the work they did on Skyrim, it could happen and be a neat addition to the series.
Considering that Fallout 3 went so far as to have Eulogy Jones and his sex slaves at Paradise Falls, this is a strange thing to omit from the latest game in the franchise. One has to wonder if the ESRB is getting more lenient with its ratings, as nothing in Fallout was ever explicit and other games like Halo 5: Guardians have had their ratings adjusted downward recently. Or it could be that Bethesda has changed direction creatively. In any case, we'll see the final result in just two months.