What is CC9, the 'concerning' new cannabinoid linked to hospital cases?

A new semi-synthetic cannabinoid called CC9 "demands rigorous attention", the University’s forensic laboratory said in a public awareness alert.

“The attractive packaging, which may appeal to some, and the ease of obtaining these products are extremely concerning," the lab said. 

The Medical Association of Malta (MAM) have said on Thursday that seven people have been treated in hospital over the past five days after consuming cannabis edibles that contained CC9.

What is CC9?

CC9, also known as HHC-C9, is a new semi-synthetic cannabinoid product that has been flagged by both the University of Malta’s Forensic Laboratory and the MAM.

The first reported case of this cannabinoid was in December 2024, the lab said.

Little is known about this novel drug at this stage, however, the effects of CC9 seem to be similar to those of other synthetic cannabinoid products such as CC8, the lab said.

This cannabinoid can be found in edible products such as gummies, cakes, and cookies, the MAM said. The lab added that it has also been reported to be found in e-cigarettes.

What is in these products?

Multiple packets with this cannabinoid that were being sold in Malta were submitted to be examined by the lab.

The lab found that all these packets had “green herbal material”, which included the synthetic cannabinoids CC9 and 9-HHC, as well as delta-9-THC, which is the active ingredient found in cannabis.

All the products analysed by the laboratory that included CC9. Photo: Forensic Analysis Laboratory

The packages analysed by the lab were labelled as being “Not For Human Consumption" or "For Research Purposes Only”. The MAM reported seeing the same texts on packages that patients brought into the hospital.

“This gross mislabelling significantly increases the danger associated with these products,” the lab said.

“By stating they are not safe for human consumption, they are trying to go around the law... It’s like I’m selling you a souvenir. You’re not supposed to eat it, but it’s a cake,” vice-president of MAM, Jeffrey Bonnici, said.

What are its effects?

Not much is known, but anecdotal consumer reports suggest that the effects of this drug "may be subjectively similar to those of cannabis", the lab added.

The lab noted how the European Union Drugs Agency (EUDA) recently received a report from Italy about patients suffering from “acute poisoning” after consuming this drug.

“The report of acute poisonings abroad and the presence of a novel semisynthetic cannabinoid, which has yet to be studied, demand rigorous attention,” the lab said.

The lab also raised concerns about the high doses found in these products, which raises concerns about the "potential public health implications".

The MAM reported that their patients suffered extreme drowsiness lasting over 24 hours, vomiting, vision problems and liver damage.

Although the patients experienced terrible symptoms for many hours, MAM vice president Jeffrey Bonnici said that “it’s very unlikely that they will die from this”.

Bonnici explained that because the effects of an edible take longer to kick in than smoking cannabis, sometimes over an hour, many people end up eating too much as they do not feel the immediate effects.