An Associated Press analysis has found existing medical marijuana programs take a hit when states legalize cannabis for all adults over age 21.
In the most extreme case, the AP found the number of medical cardholders in Oregon dropped nearly two-thirds.
Alaska's registry dropped by 63%, followed by Nevada with nearly 40% and Colorado with 19%.
Patients in those states who rely on medical marijuana say they are left with fewer and more expensive options.
It's a paradox playing out nationwide as more states take the leap from care-centered medical programs to recreational models aligned with a multibillion-dollar global industry.
David Mangone, director of government affairs for Americans for Safe Access, says states see a "massive exodus" of medical patients when they legalize marijuana for all adults — and then, in many cases, the remaining ones struggle.