Finding the Right Amount of Medical Marijuana: Why Titration Matters

Titration is a fancy way of saying you slowly increase the dose of a medication to find the right amount for you. It's especially important with medical marijuana because everyone reacts differently. What works wonders for one person might not do much for another, or even cause unwanted side effects.

That's why titration is key. You start with a low dose, often through microdosing (taking a very small amount). Then, you gradually increase the dose over time, typically every few weeks, until you find the "sweet spot" – the minimum effective dose (MED) that treats your condition without causing side effects.

This "start low and go slow" approach is crucial, especially for those new to medical marijuana, particularly products with THC. Microdosing helps minimize any psychological effects, like euphoria, so you can get used to the feeling before increasing the dose.

By titrating, you can maximize the benefits of medical marijuana while minimizing any potential downsides.

If you would like to take a deeper look into Medical Titration, please check out this article: ”The art and Science of Drug Titration.” 

Source: Caffrey AR, Borrelli EP. The art and science of drug titration. Ther Adv Drug Saf. 2021 Jan 19;11:2042098620958910. doi: 10.1177/2042098620958910. PMID: 33796256; PMCID: PMC7967860.

How to Determine Titration

Your minimum effective dose may be a couple of puffs from a joint, a single drop of tincture, or several inhalations from a vaporizer pen. The best way to discover it is to start with a small amount, wait an appropriate amount of time, and then take another small dose. Using this method can help you find your optimal balance of effects.”

Smoking & Vaporizing Cannabis

Examples of smoking and vaping products:  Flower, Concentrates, Cartridges

Inhalation is a popular way to consume cannabis, traditionally through joints or pipes. However, vaporization offers a potentially healthier alternative. Vaporizers heat cannabis at a lower temperature than smoking, reducing the amount of carcinogens inhaled and creating a purer vapor. This method remains a fast and effective way to experience the effects of cannabis.

Concentrates & Cartridges

For those who typically have a higher tolerance or are more seasoned in in-taking Cannabis. Vape pens and cartridges have become more affordable and 

popular recently. Products range from disposable to refillable cartridges that attach to a battery-powered heating element. Although the effects are felt much faster

when Cannabis is smoked or vaporized, it is still advisable to take a few minutes in between puffs when familiarizing oneself with a new strain or this delivery method. 

Cannabis Edibles

Examples of different types of edibles: Gummies & Chews, Infused Brownies, Dissolvable strips, and Cannabis Beverages.

Unlike smoking or vaping, edibles take a longer time (anywhere between 30 minutes to 2 hours) to kick in because they're processed first by the stomach and second by the liver. Edibles can feel stronger than inhaled cannabis due to the presence of 11-hydroxy-THC, a metabolite created by the liver. However, the overall effect is likely due to a combination of factors, including 11-hydroxy-THC's potency, dose consumed, and individual metabolism.

The effects can vary depending on factors like weight, height, age, and whether you have food in your stomach (an empty stomach could possibly lead to faster and stronger effects). Remember, you can always consume more but not take back what you've eaten. So start off with a small dose, and work your way up. 

For example: If it's a 5 mg gummy, consume half or 2.5 mg, and then wait to see how you feel. If you need desire a stronger effect then try consuming another gummy and again wait (30 mins/ 1 hour) to see how you feel. If it's a 10 mg gummy, cut the edible in half and start with that half first. Wait a few hour/s, and see how you feel and if you need more take the other half. Always check the products ingredient list for allergens.

  • Edibles can be potent: They can be much stronger than inhaled cannabis, so it's important to start with a low dose.

  • Slow onset: The effects of edibles take longer to kick in (up to several hours) compared to smoking.

  • Gradual increase: Because of the slow onset, it's important to wait and see how you feel before consuming more.

  • Possible risks: Some potential side effects of edibles: anxiety, paranoia, and/or dizziness. Allergens: Always look for an ingredient list and check for potential allergens.

  • Legality: Edibles may not be legal in your state. Make sure to know your state laws and your rights as a patient.

RSO (Rick Simpson Oil) 

What is RSO? Put simply, Rick Simpson Oil, created by Rick Simpson is a well known cannabis concentrate in the medical cannabis world. It is a whole plant extraction that is dark and tar-like and straddles the line of concentrate, edible and topical.  It can be applied as a Sublingual (possible application: under the tongue, and/or mixed with a fatty oil and typically has a quicker response time than digesting edibles.

There is quite a bit of information online about patients claiming RSO’s benefits while going through various types treatments, mostly cancer, but there is no solid evidence for it. As an incredibly potent THC product, RSO can potentially offer therapeutic effects, such as extreme pain relief and appetite stimulation, and may aid with sleep and nausea. For more information, check out Rick Simpson’s Official Website.

Cannabis Topicals + Salves

Example: Lotions, Creams, Salves, Sprays, and Roll-ons. 

For targeted relief, topicals and salves may be an option for you. As they can mostly be applied directly to the area experiencing symptoms. However the effects and symptomatic relief can vary greatly between patients. Remember: Always check the ingredient list for potential allergens and test on a small area of skin first prior to use. Be aware that certain transdermal patches may utilize permeation enhancers to facilitate the medication's absorption through the skin. 

Before using any lotions, creams, salves, sprays, roll-ons, or patches:

  • Check the ingredients list for allergens.

  • Test a small amount on your skin first. Be aware that some patches contain ingredients that might irritate or cause an allergic reaction.

Additional Tips for Titration

  • Track your experience: Keep a journal to record the product you used, the dosage, the time it took to feel effects, and the overall experience.

  • Listen to your body: Pay attention to how you feel after consuming cannabis. If you experience any side effects, it's a sign to slow down or adjust your approach.

  • Work with your doctor: If you're new to medical cannabis, consult a doctor familiar with its therapeutic uses. They can guide you through the titration process and ensure it aligns with your treatment goals.

Remember, "start low and go slow" is the golden rule of medical cannabis titration. This allows you to find the most effective dose for your needs while minimizing potential side effects.