By BERNARD CONDON and TOM KRISHER

NEW YORK (AP) — It was an accident, not terrorism, but this week’s helicopter crash on the roof of a midtown Manhattan skyscraper has raised serious security concerns because of the ease with which the chopper ventured into one of the nation’s most tightly restricted no-fly zones.

Some of the questions being posed are the same ones that bedeviled authorities after 9/11 nearly two decades ago: Are they able to react quickly enough to a rogue aircraft? What can they realistically do? Is scrambling fighter jets and shooting down the intruder really feasible over densely populated city streets?

“If someone had bad intent and they took off from the heliport and made a beeline to Trump Tower, none of the good guys are going to get in the air fast enough to stop him,” said Steven Bucci, a retired Army Special Forces officer who help design the post-9/11 system to guard U.S. airspace.

Ever since President Donald Trump’s election in 2016, a one-mile (1.6-kilometer) radius around Trump Tower has been designated National Defense Airspace, one of the highest-level restrictions, requiring express permission from the Federal Aviation Administration for any flights below 3,000 feet (914 meters) and constant radio communication with air-traffic control.

Pilots who don’t adhere to the restriction, according to the FAA, may be “intercepted, detained and interviewed by law enforcement” and “the United States government may use deadly force … if it is determined that the aircraft poses an imminent security threat.”

Investigators say the pilot who died in the crash Monday afternoon just a few blocks from Trump Tower did not seek such permission and didn’t contact air-traffic control because he wasn’t required to do so, given his intended route, which was supposed to take him around Manhattan to the helicopter’s home base in New Jersey.

After taking off from a heliport on Manhattan’s East Side, the chopper instead strayed over midtown in heavy rain and thick fog and slammed into the roof of the 750-foot (229-meter) AXA Equitable building during an 11-minute flight.

An official who was briefed on the situation and spoke on condition of anonymity because the federal investigation is still going on said that 58-year-old commercial pilot Tim McCormack radioed just before the crash that he was lost and trying to get back to the heliport.

Whether anyone noticed the plane’s intrusion into the no-fly zone before the crash is unclear. The FAA and National Transportation Safety Board officials said that question is under investigation. The New York Police Department has a squadron of helicopters that patrol the city’s airspace, but none were in the air at the time of the crash.

“I think the FAA needs to look at this very carefully,” he said on CNN. “Do they need to toughen up their rules or put more security or monitoring of the situation to make sure something like this couldn’t happen again?”

The airspace over certain areas — key government buildings and defense installations, for example — has long been off-limits to planes and helicopters. The use of temporary flight restrictions, or TFRs, grew rapidly after the Sept. 11 attacks and came to include bans over major sporting events and areas around presidential visits.

Federal and civilian air officials say it is not unusual for pilots to venture into such areas without permission, and normally it is just a mistake by a pilot who has strayed off course. Air traffic controllers try to reach the pilot by radio and tell the person how to safely leave the area and land at an airport, and pilots usually cooperate.

In the rare cases when the pilot doesn’t answer the radio or disobeys a controller’s instructions, the FAA contacts government agencies such as the Air Force or Homeland Security to intercept the offending aircraft and guide it out of the no-fly zone. If that doesn’t work, authorities may take more drastic action.

On Sept. 11, 2001, fighter jets were scrambled from bases in Virginia and Massachusetts to engage the hijacked passenger planes, but the airliners went down before the jets could get close.

No aircraft has been shot down over the U.S. since 9/11, but there have been many cases that came close. Last August, after a ground crew employee at Seattle-Tacoma International Airport stole an empty plane and started doing aerobatic stunts, F-15 jets took off but did not fire. The plane crashed on a sparsely populated island, killing just the hijacker.

John Desmarais, operations director for the Civil Air Patrol at its headquarters near Montgomery, Alabama, said the decision to shoot down a plane would be complicated in New York City. Firing a missile over the city of 8 million people and blasting a plane to pieces, causing a shower of flaming debris, would itself be extraordinarily dangerous.

“I would not think that they would do that over the city, but it depends on what the threats are and the needs at the time,” Desmarais said. “Everybody is going to do their best, but in the end, it would be a tough decision to have to make no matter where that is.”

From 2016 to 2018, the North American Aerospace Defense Command says, it has responded to about 500 flights flagged by FAA as entering no-fly zones without permission or displaying “erratic” behavior. Of those, NORAD says, the military or local law enforcement sent aircraft on intercept missions 164 times.

NORAD spokesman Cameron Hillier said he did not have figures for the number of intercepts in New York City. But nearby areas in New Jersey reportedly have had plenty. The North Jersey Record reported that aircraft were sent to intercept violators around Trump’s golf course in Bedminster, New Jersey, 29 times in 2017 alone.

Hillier said air combat stations are “spread throughout the U.S. and Canada and are capable of responding to any aircraft,” but he would not disclose the number of fighter jets in the New York City area.

Jeffrey Price, a pilot and aviation security expert at Metropolitan State University of Denver, said military commanders would need “extraordinary, credible information” about a threat before ordering a plane to be shot down.

“Fortunately since 9/11 we’ve never had to come to that conclusion of shoot or don’t shoot,” he said. “To make that decision, there is going to have to be a lot of evidence to say, ‘This thing is a threat and the only way to solve this problem is to put a missile into it.’”

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Associated Press writers Michael R. Sisak in New York and David Koenig in Dallas contributed to this report.

PORTLAND, Ore. (AP) — 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 The 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.

“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.”

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.

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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.

“Lots of people have started trying to figure out how to make these concentrates and edibles themselves in their kitchen,” 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.”

The numbers compiled by the AP through public records requests and publicly available documents provide a snapshot of the evolution of marijuana as more states — Michigan was last in the door, and Illinois is about to follow — legalize pot for all adults.

Ten states have both medical and recreational markets. Four of them — Oregon, Nevada, Colorado, Alaska — have the combination of an established recreational marketplace and data on medical patients. The AP analysis found all four saw a drop in medical patients after broader legalization.

In Alaska, the state with the second-biggest decline, medical cardholders dropped by 63{99cd714f394079a7f0ed2eb1518dd31342ff3ceb5b6c267c3ad8acd5b5a7d66b} after recreational sales began in 2016, followed by Nevada with nearly 40{99cd714f394079a7f0ed2eb1518dd31342ff3ceb5b6c267c3ad8acd5b5a7d66b} since 2017 and Colorado with 19{99cd714f394079a7f0ed2eb1518dd31342ff3ceb5b6c267c3ad8acd5b5a7d66b} since 2014.

The largest of all the legal markets, California, doesn’t keep data on medical patients, but those who use it say their community has been in turmoil since recreational pot debuted last year. That’s partly because the state ended unlicensed cannabis cooperatives where patients shared their homegrown pot for free.

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. Oklahoma has among the more liberal guidelines for use and has approved more than 100,000 patient licenses since voters backed legalization last June.

Getting a precise nationwide count of medical patients is impossible because California, Washington and Maine don’t keep data. However, absent those states, the AP found at the end of last year nearly 1.4 million people were active patients in a medical marijuana program. The AP estimates if those states were added the number would increase by about 1 million.

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

In Michigan, where medical marijuana has been legal for over a decade, the creation of a new licensing system for medical dispensaries has sparked court challenges as the state prepares for the advent of general marijuana sales later this year. A cancer patient there filed a federal lawsuit this month, alleging the slow licensing pace has created a shortage of the products she needs to maintain her weight and control pain.

In Washington, medical patients feel they were pushed aside when that state merged its medical and general-use markets, which also is what’s happening in California.

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{99cd714f394079a7f0ed2eb1518dd31342ff3ceb5b6c267c3ad8acd5b5a7d66b} 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 formed to oversee the market transition 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.”

General legalization has “indelibly changed the medical market,” and regulators want to identify the patients most affected by the transition, said Steve Marks, executive director of the Oregon Liquor Control Commission, which oversees Oregon’s recreational marijuana program.

Lawmakers just passed a bill that includes language that will allow the commission to explore a pilot program for home delivery of medical cannabis to patients in underserved areas, he said.

Meanwhile, Oregon U.S. Attorney Billy Williams has demanded lawmakers get control of excess weed being trafficked out of state and cited the medical industry as a potential source of illicit cannabis.

As a result, lawmakers are “paring the medical program back to what it probably should have been from the outset,” said Ben Pirie, a cannabis law attorney in Portland.

“There are patients with legitimate needs, but there are many more growing way more cannabis than needed to address those needs — and what do you do with that?” Pirie said, adding “there is this sweet spot in the middle that’s difficult to hit.”

Oregon law allows medical patients to shop tax-free at general-use stores, and recreational stores can sell medical pot, although those products comprise just 8.5{99cd714f394079a7f0ed2eb1518dd31342ff3ceb5b6c267c3ad8acd5b5a7d66b} of their sales.

Meanwhile, the rules that came with general legalization put lower caps on the potency of edibles. That means medical customers often pay more for the same dose they got before broad legalization.

Medical cardholders, for example, used to buy gummies or chocolate bars infused with 400 mg of THC, the high-inducing element of cannabis. Now, edibles are capped at 100 mg for medical patients but cost the same or more.

“Who, with any medical condition, needs to be eating 20 pieces of candy a day?” asked Erich Berkovitz, Oregon’s last remaining state-licensed medical marijuana processor.

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Patients can also grow a small number of plants, but that doesn’t address the needs of the many medical patients who don’t smoke and instead rely on marijuana-infused edibles or tinctures.

Bill Blazina, a Navy veteran, used the state’s medical program in 2013 when he was diagnosed with esophageal cancer. But the 73-year-old grandfather found the landscape had changed dramatically when he was diagnosed last year with a new cancer in his lung.

The highly concentrated marijuana oil he took before — and wanted to take again — was selling for $60 a gram, his daily dose. A two-month supply would cost thousands at a retail pot shop, so Blazina connected with what he calls a “compassionate grower” who sold him the same amount at cost for $750, a transaction that fell in a legal gray area.

“I didn’t even know his name,” said Blazina, sitting in a rocking chair in his home in the tiny coastal town of Waldport. “I met him … and he’d bring it to me and smile, and I’d give him money and say, ‘Thank you,’ and I’d be on my way.”

After surgery and chemo, his cancer is in remission, but he still swallows a tiny drop of the oil on a piece of tortilla twice a day. He’s learned how to make it himself: He and his neighbor combine their eight legal plants, pulverize a pound (0.45 kilograms) of marijuana flower, steep it in grain alcohol, strain it and then simmer the resulting mix of alcohol and plant juice in a rice cooker until only dark black oil is left.

A pound of that flower at a retail store would be about $2,000, Blazina said.

“I think the regulations should go toward more access and how do we get more access, realistically, for the people who need it medically,” he said, before taking his afternoon dose. “It prohibits people who don’t have the ability to grow from getting the medicine they need because it drives the price up — and I don’t see that as being helpful at all.”

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Kastanis is an AP data reporter in Los Angeles. Associated Press writers David Eggert in Lansing, Michigan, and Michael R. Blood in Los Angeles contributed to this report. Flaccus, Kastanis and Blood are members of AP’s marijuana beat team. Follow Flaccus on Twitter at http://www.twitter.com/gflaccus. Follow AP’s complete marijuana coverage: https://apnews.com/Marijuana.