Methods: 24 young adults (aged 18-28) living in a state where cannabis is recreationally legal were recruited for a one-hour interview on cannabis-involved sexual experiences. At the end, participants were asked to provide three recommendations for a friend considering combining cannabis and sex. The interviews were transcribed and analyzed using thematic analysis.

Results: While participants listed a variety of recommendations, three main themes were documented: 1) realize cannabis is a unique substance when it comes to sexual activity, 2) know your sexual partner to ensure open communication and reduce the risk of experiencing sexual violence, and 3) focus on incorporating accommodations that will lead to positive sexual experiences.

Conclusions: Young adults offered harm reduction-based advice, emphasizing gradual use to avoid overconsuming, prior cannabis experience, and clear communication while high. They also noted that cannabis is a substance that distorts perception differently than other substances, requiring one to feel confident making decisions in an altered reality. These insights affirm that young adults are developing norms to make consensual sex while high possible and offer valuable guidance on comprehensive sexual consent education.