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When states legalize pot for all adults, long-standing medical marijuana programs take a big hit, in some cases losing more than half their registered patients in just a few years, according to a data analysis by Associated Press.

Much of the decline comes from consumers who, ill or not, got medical cards in their states because it was the only way to buy marijuana legally and then discarded them when broader legalization arrived.

But for people who truly rely on marijuana to control ailments such as nausea or cancer pain, the arrival of so-called recreational cannabis can mean fewer and more expensive options.

There is limited scientific data backing many of the health claims made by medical marijuana advocates, and the U.S. government still classifies cannabis in any form as a controlled substance like LSD and cocaine.

Still, the popularity of medical pot is rising as more states legalize it. There are 33 such states, including the politically conservative recent additions of Oklahoma and Utah.

Some costs triple

Robin Beverett, a 47-year-old disabled Army veteran in California, said she resumed taking a powerful prescription mood stabilizer to control her anxiety and PTSD when the cost of her medical marijuana nearly tripled after the state began general sales.

Before last year, an eighth of an ounce of dry marijuana flower cost her $35. Now it’s approaching $100, Beverett said.

“It’s ridiculous. The prices are astronomical,” said Beverett, who moved to Sacramento from Texas because medical marijuana is illegal there. “Going to the dispensary is just out of the question if you’re on any kind of fixed income.”

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.

States see a “massive exodus” of medical patients when they legalize marijuana for all adults — and then, in many cases, the remaining ones struggle, said David Mangone, director of government affairs for Americans for Safe Access.

“Some of the products that these patients have relied on for consistency — and have used over and over for years — are disappearing off the shelves to market products that have a wider appeal,” he said.

Cost also rises, a problem that’s compounded because many of those who stay in medical programs are low-income and rely on Social Security disability, he said.

Fewer products for pain

In Oregon, where the medical program shrank the most following recreational legalization, nearly two-thirds of patients gave up their medical cards, the AP found.

As patients exited, the market followed: The number of medical-only retail shops fell from 400 to two, and hundreds of growers who contracted with individual patients to grow specific strains walked away.

Now, some of the roughly 28,000 medical patients left are struggling to find affordable medical marijuana products they’ve relied on for years.

While the state is awash in dry marijuana flower that’s dirt cheap, the specialized oils, tinctures and potent edibles used to alleviate severe illnesses can be harder to find and more expensive to buy.

“Lots of people have started trying to figure out how to make these concentrates and edibles themselves,” said Travis MacKenzie, who runs TJ’s Gardens, which provides free medical cannabis to children with epilepsy.

“There are things that we don’t really want people to do at home, but the market conditions are such that people are trying to do more at home.”

As more states legalize marijuana for all adults, some who have been using it medically are feeling disenfranchised.

Los Angeles dispensary owner Jerred Kiloh sells medical and recreational marijuana and said those markets are quickly becoming one, since few companies are going to produce products for a vanishing group of customers. He said his medical business has dipped to 7% of overall sales and is dropping month to month.

“It’s going to be gone,” said Kiloh, president of the LA trade group United Cannabis Business Association.

In Oregon, regulators are struggling to find a path that preserves the state’s trailblazing low-cost medical pot program while tamping down on a still-thriving black market.

A special state commission put out a report earlier this year that found affordability and lack of access are major hurdles for Oregon’s patients.

“Patients have needs. Consumers have wants,” said Anthony Taylor, a medical marijuana advocate who sits on the Oregon Cannabis Commission. “Patients are in crisis right now.”

     —AP