Background: Moral judgments depend on the integration of complex cognitive and emotional processes. Addiction is associated with core deficits in both cognitive and emotional processing, which may jointly lead to utilitarian biases in moral decision-making. Methods: We assessed 32 polysubstance dependent males and 32 non-drug using controls using a previously validated moral judgment task, including non-moral scenarios, and moral dilemmas that were either high in emotional salience (?personal scenarios?) or low in emotional salience (?impersonal scenarios?). Results: Polysubstance dependent individuals endorsed more utilitarian choices for personal dilemmas (e.g., smothering a baby to save a group of hidden people during wartime). These choices were also perceived as less difficult. Severity of alcohol use correlated with the proportion of utilitarian judgments. Conclusion: Polysubstance dependent individuals show a more utilitarian pattern of moral decision-making for personal moral scenarios.