Medical marijuana activists just won a surprise victory in North Dakota - that northwestern hotbed for progressive politics. State voters just approved the medical marijuana legalization initiative (Measure 5) by a wide margin, according to Politico. As of 11 pm ET, the yes vote led by nearly a two-to-one margin.

That means patients with HIV, Crohn's, PTSD, cancer or other qualifying conditions will soon be able to legally access medical marijuana.

Unlike the other states voting on medical marijuana this year, there wasn't a group running a "Vote No" campaign against Measure 5. But the path to Election Day wasn't a walk in the park for activists in the Peace Garden State.

North Dakota is notoriously conservative. In fact, it's one of only a few American states where marijuana was completely prohibited. So it's not surprising that support for legalization looked weak leading up to Election Day. According to polling data released by the University of North Dakota in 2014, only 47 percent of voters supported medical marijuana while 41 percent were opposed and 9 percent were undecided. 

So there was no clear support for legalization. And the fact that newer data wasn't available suggested that the majority of North Dakotans weren't particularly interested in discussing the issue. 

But they surprised us all by showing up to the polls and making North Dakota the 28th state to legalize medical marijuana. Florida became the 27th state earlier this evening.

The victory in North Dakota helps activists gain a stronger foothold in the Midwest, which is one of America's most unfriendly regions when it comes to marijuana reform.