A new report by the National Academies of Sciences, Engineering and Medicine finds that the disconnect between federal and state governments has complicated efforts to develop cannabis policies that protect public health. The report calls for federal public health leadership on cannabis policy.

More than half of all U.S. states have legalized some form of cannabis, while the federal government still considers most types of cannabis illegal. According to the report, the disconnect between state and federal government regarding marijuana is leading to fragmented policies and risks to the public, NPR reports.

The report finds that people consume cannabis more regularly than alcohol in the U.S. The concentration of THC found in many cannabis products can be very potent, which is not always disclosed. Higher concentrations of THC make it more likely for people to take more than they intend to. This has contributed to more traffic accidents and hospital visits related to cannabis use, the report notes.

It is possible to obtain psychoactive hemp products even in states where cannabis is illegal, the report finds. This is because the 2018 Farm Bill defined a subset of cannabis as hemp, and excluded it from the Controlled Substances Act. As a result, there has been a boom in products containing hemp-derived chemicals. The report also found that cannabis can be dangerous, but the public tends to hear less about its risks.