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Introduction: The aim of this paper was to examine the client and psychosocial characteristics associated with polydrug use in patients with alcohol misuse as their primary drug of concern (PDC) seeking treatment from substance use treatment centres. Methods: Self‐report surveys were undertaken with clients attending 1 of 34 community‐based substance use treatment centres across Australia with alcohol as their PDC. Survey items included client's socio‐demographic characteristics, level of alcohol dependence, use of other drugs including tobacco, health and wellbeing factors including health‐related quality of life. The factors associated with polydrug use (alcohol use concurrent with at least one other drug) were examined. Results: In a sample of 1130 clients seeking treatment primarily for alcohol problems, 71% reported also using another drug. The most frequently used drug was tobacco (50%) followed by cannabis (21%) and benzodiazepines (15%). Excluding tobacco use, 35% of participants reported polydrug use. Factors associated with any polydrug use were younger age, lower education levels, lower levels of mental health related quality of life and housing risk (i.e., risk of eviction or experienced homelessness in past 4 weeks). When tobacco was excluded, factors associated with polydrug use were age, lower physical and mental health‐related quality of life, and housing risk. Discussion and Conclusions: Most adults seeking treatment for alcohol misuse as their PDC reported using another drug in addition to alcohol. Treatment services should be designed accordingly to maximise the likelihood of treatment engagement and success. [ABSTRACT FROM AUTHOR]