Change seemed imminent in January for patients of a troubled drug addiction program in Baltimore. State health regulators said they would be transferred to new treatment providers and moved out of squalid, drug-ridden and roach-infested apartments. Some patients hoped they would at last get the help they needed.

But little improved in the months that followed, some former patients of the program, PHA Healthcare, said in interviews.

Many patients said they had continued to live in the same buildings, operated by the same people. It was not always clear to them what company was providing counseling. But they attended sessions online, as they had before — sometimes led by the very same overseas counselors who had previously treated them and appeared to lack state licenses.

Drug use in the buildings remained common, said some of the patients, who declined to be identified for fear of retaliation, including possible eviction.

One woman described trying to stay off drugs while living with people who were using them, and attending online group counseling sessions that she said had provided little help. “By God’s grace I haven’t relapsed,” she said.