Recreational marijuana use is linked with an increased risk of emergency room care and hospitalization for any reason, according to new research.

Researchers at the University of Toronto examined national health records for more than 30,000 people ages 12 to 65 over a six-year period. They found people who used recreational marijuana were 22% more likely to visit an emergency room or to be hospitalized, compared with people who did not use marijuana. The findings held true even after researchers adjusted for factors including use of other substances, HealthDay reports.

Physical bodily injury was the leading cause of ER visits and hospitalizations among people who used marijuana, followed by respiratory-related issues.

Linda Richter, vice president of prevention research and analysis at Partnership to End Addiction, said the study provides more evidence of the unintended consequences of marijuana legalization.

“The growing notion that marijuana use is harmless and even medicinal for the general public —a belief pushed by the cannabis industry and the legalization movement — is especially dangerous given the steep rise in the drug’s potency in recent years, the many toxic chemicals that are in the various types of marijuana products, and the increasing accessibility of the drug to people of all ages, especially children and adolescents who are most vulnerable to its effects,” Richter said.