Cannabis and Tinnitus in HIV and Non-HIV Individuals

Cannabis use was not linked to whether people experienced tinnitus, but it was associated with them reporting their tinnitus as less severe. This is the conclusion of a recent analysis of over 3,400 adults, published in The Open Public Health Journal by researchers Chukwuemeka N. Okafor, Deanna Ware, and Andrew Edmonds.

How the Study Investigated Cannabis and Tinnitus

The researchers used data from the MACS/WIHS Combined Cohort Study (MWCCS), a long-running observational study focused on HIV. They analyzed cross-sectional information collected from participants between October 2020 and September 2022.

Tinnitus was defined as “bothersome ringing, roaring, or buzzing in the ears or head” lasting at least five minutes in the past year. Those who had it rated its severity as “no/small problem” or a “moderate to very big problem.” Cannabis use was based on self-reported frequency over the previous six months.

The team then used statistical models to look for associations, carefully adjusting for many potential confounding factors. These included age, sex, race, HIV status, noise exposure, self-rated hearing, smoking, and depression. For participants with HIV, they also adjusted for viral load and medication history.

Cannabis Linked to Lower Reported Severity, Not Presence

The cohort of 3,437 participants had a mean age of 55, was 55% female, and included 63% people living with HIV (PWH). The analysis yielded two clear, distinct results.

First, there was no statistically significant association between cannabis use and whether a person reported having tinnitus at all. The prevalence of tinnitus was similar between users and non-users after accounting for other variables.

The second finding was more striking. Among those who did have tinnitus, any cannabis use was associated with a 29% lower prevalence of reporting that tinnitus as a moderate-to-severe problem. The adjusted prevalence ratio (aPR) was 0.71, with a confidence interval (0.54–0.94) that excluded 1.0, indicating statistical significance.

When the researchers looked separately at people with and without HIV, the effect was most pronounced in the group without HIV. In that subgroup, any cannabis use was linked to a 42% lower prevalence of moderate-to-severe tinnitus (aPR=0.58; 95% CI: 0.37–0.90).

What Could Explain the Severity Link?

The authors propose that cannabis may not stop the phantom sound of tinnitus but could change how the brain perceives or reacts to it. Cannabinoid receptors are present throughout the central auditory pathway and brain regions involved in emotion, attention, and stress.

“These findings suggest that cannabis may influence the subjective burden of tinnitus rather than its occurrence,” Okafor and colleagues write. The psychoactive effects of THC or the anxiolytic properties of CBD could potentially alter a person’s emotional response to the sound, making it less distressing. This is plausible given the established link between tinnitus, hyperacusis, and anxiety. By reducing the anxiety component, cannabis might make tinnitus feel less severe.

An alternative explanation is that people who use cannabis for symptom management might already have more severe tinnitus. The cross-sectional design cannot determine causality—it cannot tell if cannabis reduces severity or if people with less severe tinnitus are more likely to use cannabis.

Implications and the Need for Caution

For patients and clinicians, this study offers a nuanced perspective. It directly addresses a common patient question: “Will cannabis help my tinnitus?” The evidence suggests it is unlikely to make the sound disappear, but it might, for some individuals, reduce the perceived burden and impact on daily life.

This connects to a broader understanding of tinnitus management, where the goal is often not elimination but habituation and reduced distress, similar to approaches in managing misophonia. The potential impact on sleep is also critical, as distress from tinnitus can significantly disrupt sleep, creating a bidirectional cycle that worsens both conditions. Any intervention that reduces nighttime distress could be beneficial.

The researchers are careful to label their findings as hypothesis-generating. The study has limitations, including its cross-sectional nature, reliance on self-reported data, and the potential for residual confounding. They conclude that longitudinal studies are needed to confirm whether cannabis use leads to lower tinnitus severity over time.

Given the complex legal status and varying chemical compositions of cannabis products, patients should not interpret this as a green light for self-medication. The association found was with “any use,” and the study did not analyze different strains, potencies, or methods of consumption. Consulting a healthcare provider remains essential.

The full study, “Cannabis Use and Tinnitus in People with and without HIV,” is available via DOI: 10.2174/0118746136457303260813073100.