Alex Pavich is the last person you’d expect to be on the fence about marijuana legalization.

The 39-year-old is a longtime marijuana consumer, using it to treat old injuries and calm his nerves. Pavich and his girlfriend, Aligra Rainy, 28, opened one of the first medical marijuana dispensaries in Portland, helping to launch what is now a regulated industry in Oregon. Today their shop, Collective Awakenings, is among the more well-known medical marijuana retailers in the state and bustles with patients.

But Pavich isn't sure whether he’ll vote for Measure 91. The measure on November’s ballot would open the door to recreational marijuana in Oregon and make the state one of only three in the U.S. to allow anyone over 21 to possess pot.

Pavich, a medical marijuana grower, worries recreational pot will shift the focus from patients to profit.

“We are in the 21st century gold rush,” he said. “I see a lot of dollar signs in people’s eyes.”

In Oregon, one of 23 medical marijuana states, patients may possess up to 24 ounces of cannabis at any time. They can grow up to six mature marijuana plants and 18 immature ones, or have someone do it for them. With few exceptions, medical marijuana sold in Oregon’s dispensaries is not taxed. Patients must see a doctor annually to renew their medical marijuana card and they must have one of a handful of qualifying conditions, such as pain or cancer. Their names are included in a cardholder registry maintained by the Oregon Health Authority.

By contrast, Measure 91 allows anyone 21 and older to possess up to eight ounces of pot per household and grow up to four marijuana plants. The Oregon Liquor Control Commission would oversee the retail market for recreational marijuana and anyone 21 and older could purchase up to an ounce of pot, which would be taxed.

Alex Rogers, who owns a medical marijuana clinic in Ashland and has organized informational conferences about the state's burgeoning marijuana industry, speculates that if pot is legalized, medical marijuana will eventually fade away.

“It’s the beginning of the end,” said Rogers, who said he will vote for the initiative.

Organizers of Measure 91 have tried to deliver the opposite message to Oregon’s medical marijuana community, insisting that the program will not be affected by legalized pot.

They repeated the pledge to a gathering of dispensary owners in Portland late last month. At one point during the private event, Anthony Johnson, chief petitioner for the initiative, asked a reporter for The Oregonian to leave, saying the presence of the press prevented a “frank and open” conversation between the campaign and medical marijuana dispensary owners.

“I think what they are afraid of is that word will get out that some of us are not for this law,” said Bee Young, who owns Wickit Weedery, a Springfield dispensary and attended the campaign event. “That is what they don’t want people to hear, that we have concerns.”

In Washington, advocates for Initiative 502 offered a similar reassurance to that state’s medical marijuana community.

"And literally that was untrue," said Hilary Bricken, a Seattle attorney whose practice focuses on marijuana businesses. "Although in theory it may have been true, once I-502 went through, the Legislature immediately said, 'What about medical marijuana? Why is it not regulated? Why is it not taxed? Do we really need it?'"

Said Bricken: “It called into question the legitimacy of medical marijuana and the need for two systems.”

Unlike Colorado, where a regulated medical marijuana program runs alongside the recreational one, Washington only regulates its recreational marijuana industry. The state is home to medical marijuana dispensaries, but they aren’t subject to state oversight.

Bricken predicts that a new recreational pot industry will want the medical program to face the same regulations. Oregon’s recreational growers and producers of marijuana-infused edible products, for instance, may push for rules for their largely unregulated counterparts in the medical industry, she said.

“The recreational industry is going to go, ‘What the hell? We are heavily regulated and you are telling me the gray market competition is going to undercut me?’” she said. “They will lobby for it.”

Vivian McPeak, a longtime cannabis advocate and executive director of Seattle Hempfest, said he voted against Washington’s legalization initiative in 2012, calling it “one of the hardest votes in my life.”

McPeak opposed the law’s impaired driving standard, its ban on home cultivation of recreational marijuana and he worried about the implications for the state’s medical marijuana program. (Oregon’s law, by contrast, doesn’t impose an intoxicated driving standard for marijuana.)

Even now he’s torn.

“This is complicated stuff,” he said. “There is no way to change 80 years of bad prohibition policy. If it happened today, I might actually vote for it.”

Oregon legalization advocates argue Washington is different. First, Oregon already has a regulated medical marijuana dispensary system. And, said Portland lawyer Leland Berger, the Oregon Legislature generally supports medical marijuana, setting it apart from Washington, where policymakers have considered a series of medical marijuana reforms, including doing away with patients’ ability to grow their own cannabis.

“We are determined to not make the same mistakes that Washington made,” said Berger.

Kris Hermes, spokesman for Americans for Safe Access, a Washington, D.C.-based medical marijuana patient advocacy group, said the organization doesn't oppose recreational marijuana laws, but worries about their effect on patients. Medical marijuana patients, for instance, shouldn't have to pay the same taxes on marijuana purchases as recreational consumers, he said.

“Taxes that are imposed on adult (recreational) users are significant and onerous for patients who may be low income or unable to afford that extra cost on a medication that is already in many cases prohibitively expensive,” said Hermes.

Morse, the Southwest Portland dispensary operator, said even though recreational marijuana means uncertainty for the future of medical marijuana, he’ll vote for legalized pot this fall.

“We can’t let our own personal economic concerns overshadow the bigger picture, which is that this isn’t working,” he said. “It’s hurt our civil liberties. … It’s time to end this and this is the best opportunity we have had in years.”

But Debra Stevens, a 55-year-old Milwaukie woman and medical marijuana patient, plans to vote no. She views the drug, which she uses to treat a range of conditions, strictly as medicine.

“And it’s a medicine that needs to be used properly,” she said. “People that want to get high, that’s their own thing.”

She said she worries the price of medical marijuana will spike, putting it out of reach for low-income people who rely on the drug for relief. She said already some dispensaries in the Portland area aren’t as focused on patients as they should be, something she suspects will only worsen if recreational pot is legalized.

“I think if it went recreational, I think greed would take over,” she said. “Human nature is what it is.”

-- Noelle Crombie