Dextromethorphan Drug Class: What Type Of Medicine Is DXM?

Last Updated: December 18, 2019

The Dextromethorphan medication class is known as morphinan (which describes many psychoactive drugs) and it’s derived from opiates, but has a very different use and effect. The DXM substance class is used as a cough suppressant that can decrease the urge to cough over the short term. DXM medicine is particularly useful for coughs, colds, and flu. According to dextromethorphan classification, it’s a safe and effective medicine for adults at therapeutic doses.
Dextromethorphan pregnancy class is defined as category A, which means this drug is also safe for pregnant and breastfeeding women. But the frequent abuse for recreational purposes makes the actual question of revising its controlling and legal classification.

Is DXM A Narcotic?

There is a lot of controversy about dextromethorphan narcotic properties. Narcotic use is still on the rise in the USA, and although DXM is not a narcotic, it used in recreational purpose in many states. As a result, there have been concerns about using DXM to get high and developing addiction in a significant amount of the US population for the last few years. Soon after it was first synthesized in 1958, it was classed as an over the counter medication. However, the product was later removed from the market, through dextromethorphan was explicitly excluded from the Controlled Substances Act (CSA) of 1970. To date, this drug does not belong to the class of narcotic substances.

A Legal Classification For DXM

The issue of dextromethorphan legality is a contentious one. Due to ongoing problems with misuse, the classification of this substance is subject to change.

Is DXM Legal?

There are a lot of issues when it comes to DXM legality in the US. American government bodies first made DXM legal back in the 1950s, and it’s used in at least 120 cough and cold products including syrups, cough drops, and DXM powder.

That’s why certain US states have taken steps to amend dextromethorphan legality by banning its sale to minors to curb recreational use. This is the group most prone to DXM brain damage and other serious side effects of overuse. So, while it is still legal in the USA, these states have started to regulate it:

  • Florida
  • New York
  • California
  • Arizona
  • Louisiana
  • Virginia
  • Washington
  • Kentucky
  • New Jersey
  • Tennessee
  • Alaska
  • Delaware

Is Dextromethorphan A Scheduled Drug?

Dextromethorphan is not a Scheduled Drug class. This means that it’s considered to be a safe medication that doesn’t need regulatory control. As a result, dextromethorphan is an uncontrolled medication that can be bought over the counter. Schedule advocates claim that dextromethorphan drug schedule may and must be changed to the “controlled” to prevent misuse and to control access to this drug. However, at this stage, there is little effort to change the Dextromethorphan Schedule by DEA Diversion Control. The intervention would be needed, and Dextromethorphan Schedule in the United States would need to be amended if free access to this drug is to be discontinued.

DXM Drug Type According To The Chemical Class

The pharmacological classification of dextromethorphan is known as morphinan. Opiates do structurally represent morphianes, but the DXM drug type is structurally similar to opioid drugs.

learning the DXM chemical classification

So, the dextromethorphan drug category belongs to a synthetic substance that only mimics some of the behaviors of opiates. It does not alleviate pain, but it can be addictive in very high doses and have a very long and problematic DXM withdrawal timeline.

Is DXM A Hallucinogen?

The hallucinogen class can cause hallucinations, which are sights, sounds, or smells that aren’t there. This medicine is not classed as a hallucinogen. However, when taken in high doses of over 1500 mg/day it can cause hallucinogenic effects. It may also induce psychotic states that include severe psychological symptoms.

Is Dextromethorphan An Opiate?

Dextromethorphan is not classed as an opiate. Opiates are drugs that are naturally derived from the opium poppy plant. Some common opiates are morphine, codeine, and other drugs used for pain relief. However, these substances are quite similar in structure with DXM, which is why using DXM for opiate withdrawal is an ongoing field of study.

Is DXM Classed As An Opioid?

Yes, this drug is classed as an opioid, which means that it’s a synthetic substance. However, it can’t bind to the opioid receptors in the brain, which is why it can’t be used to relieve pain.

A mix of DXM and kratom is a particularly bad example of this.

Is Dextromethorphan a Stimulant?

Medications with stimulant properties can cause a range of reactions, including increased activity of physical systems in the body as well as similar psychological effects. At normal DXM dosage levels, it should not have any stimulant effects. Despite not being classified as a stimulant, this drug can cause a mild stimulant effect at very high doses.

Is Dextromethorphan an NSAID?

NSAIDs are Nonsteroidal anti-inflammatory drugs that can reduce inflammation and decrease pain and fever. The medication is not classed as an NSAID as it has no effect on pain, or inflammation at average therapeutic or higher doses.

Is Dextromethorphan a MAOI?

MAOIs or Monoamine oxidase inhibitors are a class of medications that are potent antidepressants and inhibit the activity of monoamine oxidase enzymes.


Dextromethorphan is not part of the drug class known as SSRI. SSRIs or selective serotonin reuptake inhibitors act on the brain to inhibit serotonin uptake. This is very different from the effects the DXM has on the brain.

Is Dextromethorphan a Decongestant?

Decongestants are used to alleviate nasal congestion. DXM is not a decongestant, though it can be used in conjunction to relieve cold and flu symptoms. Certain products used to ease the symptoms of cold and flu will contain decongestants and DXM for this reason.

Is Dextromethorphan an Expectorant?

DXM can have a similar action to expectorants in that it’s used to treat coughs, though the mechanisms are different. The medicine acts on the brain to suppress the urge to cough, whereas expectorants encourage the secretion of sputum.

Is Dextromethorphan an Antihistamine?

The Antihistamine class is used to treat allergies and can relieve nasal congestion or other symptoms. However, dextromethorphan is not an antihistamine as it has no effect on allergy symptoms and can, in rare cases, cause allergic reactions susceptible people.

Is Dextromethorphan an Anticholinergic?

The drugs at the anticholinergic class block the neurotransmitter acetylcholine at individual synapses in the nervous system. This is very different from the action of DXM – it decreases activity in the part of the brain, which causes excessive coughing. It does this by crossing the blood-brain barrier and activating opioid receptors in the central nervous system, so this medicine is not an anticholinergic.

Dextromethorphan Drug Class: An Uncontrolled Medication

Dextromethorphan is an uncontrolled substance class, that is gradually becoming more regulated in some US states. This trend will probably continue in the future and may lead to medicine becoming scheduled.

getting DXM as uncontrolled substance

Although DXM is not in the narcotic class and is legally available in the USA, some people use it for recreational purposes. Because it is attached to an HBr molecule in cough syrup, DXM can easily be separated from the rest of the mixture. This solves any issues about how to extract DXM and makes recreational use possible. When taken in large doses as a psychoactive drug or in combinations such as dextromethorphan and alcohol, it also can be hazardous.

Misuse of this medicine can result in addiction and dependency as well as withdrawal symptoms when the drug is taken away, which is why addiction treatment may become necessary. Drug rehabilitation centers have the resources to make the withdrawal process run more smoothly and help reduce the chances of a strong adverse reaction.

Page Sources

  1. The United States 
Drug Enforcement Administration. The Controlled Substances Act (CSA).
  2. Storrow AB, Magoon MR, Norton J. The dextromethorphan defense: dextromethorphan and the opioid screen. 1995.
  3. Bridgette Martinak, Ramy A. Bolis, Jeffrey Ryne Black, Rachel E. Fargason, Badari Birur. Dextromethorphan in Cough Syrup: The Poor Man’s Psychosis. 2017.

Published on: August 6th, 2019

Updated on: December 18th, 2019

About Author

Peter J. Grinspoon, MD

Dr. Peter Grinspoon is an experienced physician with long-term clinical practice experience. As a former analgesic addict, Dr. Grinspoon knows precisely how important it is to provide patients with effective treatment and support. Medical writing for him is the way to communicate with people and inform them about their health.


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