Start low, go slow

"Start low, go slow" is a harm-reduction and therapeutic-dosing principle recommending initiation of cannabis at the lowest plausibly effective dose and gradual titration over days to weeks to minimize adverse events (anxiety, tachycardia, dysphoria, impairment) and to accommodate delayed-onset edibles. Popularized by MacCallum & Russo (2018 Eur J Intern Med), the principle recommends initiating THC at ~2.5 mg (often with CBD), titrating "over a period of as much as two weeks," and keeping total daily THC ≤30 mg to avoid psychoactive sequelae and tolerance. Rationale: cannabis's nonlinear dose-response (Childs 2017 — 7.5 mg anxiolytic, 12.5 mg anxiogenic), extreme interindividual PK variability (especially oral), edible overshoot risk, and the desirability of identifying the minimum effective dose. The phrase is now standard in Canadian, Australian, and U.S. medical cannabis guidance and the Bhaskar et al. (2021) Delphi consensus. Citations: MacCallum CA, Russo EB. Eur J Intern Med. 2018;49:12-19; Lucas CJ et al. Br J Clin Pharmacol. 2018;84:2477-2482; Bhaskar A et al. J Cannabis Res. 2021;3(1):22.