Being exposed personally to that sort of thing was bad enough but making sure it wasn't persisted in backups and my S3 buckets was way more trouble than it was worth, so I shut the service down and nuked the whole thing. I was mostly hanging out in public channels and using bridges; I only had one small group of IRL friends that I talked to on it and they practically leapt at the opportunity when I suggested moving the group chat to a different platform.
I see that "Trust & Safety" is on their list of things to tackle next, so perhaps I'll check it out when they announce Matrix 3.0.