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 There seem to be multiple relays that are just open and accept content from strangers. That’s very generous, but how do they cope with spam and abuse? 
 FWIW my FeoBlog implementation dealt with both by only accepting content signed by people who were explicitly allowed on that server, or followed by one of those people.

Are there Nostr relay implementations that can do something similar? 
 There are paid relays, you can also have private relays I thing with whitelisted npubs. Relays have many policies for spam, requests by time frame etc, by ip address etc, but the most important is at user level, if you don't follow that npub you won't see much spam.