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Too Many Pills? How San Diego Families Can Get a Real Medication Review

Older adults often collect medications from several prescribers. Here is how to get a free, professional medication review in San Diego County.

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By Diane Whitfield, CSA · September 06, 2026

Why medication lists quietly grow

Almost nobody sets out to take a dozen medications. It happens one prescription at a time. A cardiologist adds something after a hospital stay. A primary care doctor adjusts a blood pressure drug. A specialist in La Jolla starts a new medication and nobody tells the first two. A drug meant for six weeks after a fall never gets stopped. Add over-the-counter sleep aids and supplements, and the real list is longer than any single chart shows.

Clinicians call this polypharmacy. It is not automatically bad — plenty of older adults genuinely need several medications. The risk is that nobody has looked at the whole list at once, so interactions, duplicate therapies, and drugs that made sense at 68 but not at 84 hide in the gap between prescribers. The American Geriatrics Society's Beers Criteria, a periodically updated list of medications often best avoided in older adults, exists for exactly this reason: aging changes how the body handles many common drugs, so a list that was right years ago deserves a fresh look.

The free review most families never ask for

Every Medicare Part D plan is required by federal regulation to run a Medication Therapy Management program. Plans set their own targeting rules, but they generally look for people taking several medications for multiple chronic conditions, and they enroll qualifying members automatically. Many people get the letter, assume it is marketing, and throw it away.

If your parent qualifies, the core benefit is a comprehensive medication review with a pharmacist or other provider, at no additional cost. Medicare says that review should produce three things you can hold in your hand: a written summary of the discussion, a personal medication list, and a recommended to-do list to raise with the prescribing doctor. Those documents are the useful part — they travel to appointments and give the next clinician a starting point.

You do not have to wait for a letter. Call member services on the back of the plan card and ask directly whether your parent is eligible for the plan's Medication Therapy Management program. If the answer is no, the pharmacy counter is the fallback — most pharmacists will sit down for a review if you ask and bring everything.

How to run a brown-bag review that actually works

The old-fashioned method still beats any app. Put every single thing your parent takes into one bag and bring the bag to the appointment: prescription bottles, inhalers, eye drops, patches, insulin pens, vitamins, herbal supplements, and anything bought over the counter. Include the bottles you think are expired, because those are exactly the ones still sitting on the nightstand.

Bring the bottles, not a typed list. Labels show the prescriber, the pharmacy, the fill date, and the directions — and the fill dates alone often reveal a medication refilled at two pharmacies, or stopped months ago without anyone updating the chart.

Veterans are a special case. If your parent gets some medications through VA San Diego Healthcare System in La Jolla and others through a community pharmacy, neither system automatically sees the other's list — a common source of duplicate therapy, easily fixed once both lists sit side by side.

One rule holds no matter what the bag turns up: do not stop or change a medication on your own. Some drugs are dangerous to discontinue abruptly. Deprescribing is legitimate and often beneficial, but it belongs to the prescriber, usually on a taper, with a plan for what to watch.

Disposing of what comes out of the cabinet

A review usually ends with a pile of medications nobody should keep. Do not flush them, and do not leave them in the cabinet, where they are a confusion risk and a theft risk.

The San Diego County Sheriff's Office runs free, anonymous disposal kiosks at more than two dozen facilities countywide — Poway, Santee, Vista, San Marcos, Ramona, Julian, Lemon Grove, Alpine, and Rancho San Diego among them — Monday through Friday during business hours. You drop medications in like mail. Pills go in their original containers or loose into the bags at the box; liquids need sealed containers.

Needles, syringes, and lancets are different. California law bars them from household trash, and the Sheriff accepts sharps at only five sites: the Imperial Beach, Fallbrook, Lakeside, and Valley Center substations and the Rancho San Diego station. See wastefreesd.org for other options, or the DEA's year-round pharmacy locator at dea.gov/everyday-takeback-day.

When a parent lives in assisted living

Medication handling changes once someone moves into a licensed San Diego assisted living community. A residential care facility for the elderly is a non-medical setting. Under California's Title 22 regulations, staff assist residents with self-administration — reminding, storing, handing over the correct container, keeping records — while actually administering a medication requires an appropriately licensed professional. Centrally stored medications must be kept locked and accessible only to the staff responsible for them.

That distinction matters when you tour. Ask who orders refills, who notices when a prescription runs out over a weekend, what happens when a hospital sends your parent back with a changed list, and whether the community coordinates with a specific pharmacy. Get the answers written into the service plan. The California Department of Social Services publishes a medications guide and posts facility inspection reports at ccld.dss.ca.gov — read them for medication-related citations before you sign.

For help thinking this through, San Diego County Aging & Independence Services answers at 800-339-4661, and its HICAP counselors review Part D drug plans free of charge — often where a long medication list becomes a plan-choice question during fall open enrollment.

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Common questions

How many medications is too many for an older adult?
There is no magic number, and a higher count is not automatically wrong. What matters is whether one clinician has reviewed the entire list recently — including over-the-counter drugs and supplements — and can explain the reason for each item. Many geriatric teams start paying closer attention around five or more regular medications, but that is a prompt to review, not a limit.
Does Medicare pay for a medication review?
Every Medicare Part D plan must operate a Medication Therapy Management program, and for members who qualify, a comprehensive medication review is provided at no extra cost. Plans set their own eligibility rules and enroll qualifying members automatically, so call the number on the back of the plan card and ask. Members should receive a written summary, a medication list, and a follow-up to-do list.
Can I just stop a medication that seems unnecessary?
No. Some medications cause serious problems when stopped suddenly, and others are treating something less visible than their side effects. Bring your concerns and the full bottle list to the prescriber and ask specifically about deprescribing. Reducing a list is often the right call, but it should be done deliberately, usually by tapering, with agreement on what to monitor.
Where can I safely get rid of my parent's old medications in San Diego County?
The Sheriff's Office maintains free, anonymous disposal kiosks at more than two dozen stations, substations, and detention facilities across the county, open Monday through Friday during business hours. Sharps are accepted only at the Imperial Beach, Fallbrook, Lakeside, and Valley Center substations and the Rancho San Diego station; see wastefreesd.org for other sharps options and dea.gov/everyday-takeback-day for participating pharmacies.

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