Starting Thursday, Rhode Island medical marijuana patients will no longer have to pay $50 to obtain a medical card, a change that coincides with the start of recreational marijuana sales.

Five existing medical dispensaries were issued hybrid licenses to start selling recreational cannabis on Thursday, while still selling medical marijuana. The stores are the first step towards a larger process of allowing 33 retailers statewide, which could take more than a year.

With the influx of new state taxes for recreational cannabis, lawmakers did away with medical card application and renewal fees, caregiver card fees and the plant tag fees for medical patients and caregivers who grow cannabis at home.

“Patients up until today were having to pay for a card for the right to go into a dispensary,” said Ellen Lenox Smith, a medical marijuana patient, in an interview Thursday. “You don’t have to do that to go to your pharmacy to get your medication.”

Smith, who uses medical marijuana for a connective tissue disease, has long advocated for decreasing the cost of access to medical marijuana. The drug has been legal for medicinal use in Rhode Island since 2006, but the first retail compassion center didn’t open until 2013.