Association Between Cannabis Use and Tinnitus: A Multi-Center Propensity-Score-Matched Cohort Study

There are mixed findings regarding the impact of cannabis use on tinnitus, with different patterns of cannabis use potentially influencing risk in varying ways. This study investigates the association between cannabis-related disorders (CRD) and the risk of developing tinnitus.

Propensity-score-matched cohort study.

TriNetX, a multi-institutional research database.

Adult patients (>18 years) with any CRD and no prior ear-related disorders were matched to a control group of patients without any history of CRD. Patients with CRD were stratified by increasing levels of cannabis use intensity based on the ICD-10 codes (use, abuse, or dependence). Propensity score matching controlled for demographic and related clinical variables, including migraine, nicotine and substance use, and mood disorders. The primary outcome was diagnosed tinnitus at 1, 5, and 10 years, analyzed using Cox regression hazard models (hazard ratios (HR), 95% confidence intervals).

After matching (n = 92,077 in each group), tinnitus incidence after 1, 5, and 10 years of CRD diagnosis was 0.7%, 1.8%, and 2.1%, respectively. One-year risk was significantly higher among those with any CRD (HR = 1.30, [95% CI: 1.16-1.45]). Compared to control at 1-year of follow-up, effect size was relatively higher among patients diagnosed with cannabis dependence (use: 1.30 [1.11-1.51]; abuse: 1.42 [1.05-1.90]; dependence: 1.55 [1.02-2.37]). There were no significant trends in tinnitus development at 5 and 10 years of follow-up with any CRD.

Cannabis use may elevate the short-term risk of tinnitus, especially among those with more severe use. Further investigation should explore a potential dose-dependent relationship and underlying mechanisms.