Shareholders are applying pressure to drugmakers and other medical companies to try to help stem the tide of opioid addiction in the U.S., and they are making progress combating the deadly problem, according to the umbrella group leading the effort.

Investors for Opioid Accountability (IOA), which represents 53 investors with $3.5 trillion in investment funds, is using that leverage to persuade companies to be more transparent and responsible in handling opioids.

The problem of opioid addiction and overdose deaths is commanding the attention of law enforcement, politicians and the public. According to the Centers for Disease Control and Prevention, there were 70,237 drug overdose deaths in 2017, a 10% increase over the previous year, and the increase in those deaths is driven by the crisis in opioids (which were the cause of 47,000 of the deaths).

The most recent success for IOA came at the end of 2018 when Endo International, a manufacturer of generic drugs and specialty pharmaceutical products, agreed to report on its oversight of opioid business risks, enhance its corporate lobbying disclosures and take other actions to increase the transparency of its efforts to handle opioids responsibly.

Also last year, pharmaceutical distributor Cardinal Health said it would keep better track of its opioid distributions after it faced shareholder pressure led by IOA.

IOA was created two years ago by a group of investors led by the Interfaith Center on Corporate Responsibility and the United Auto Workers Retiree Medical Benefits Trust, a large investor in a number of industries, including pharmaceuticals.

A goal of the organization is to work with pharmaceutical manufacturers and distributors to get the companies to track the drugs they handle and report their efforts to the public. Members of IOA have met with officers from three large medical companies—Cardinal Health, AmerisourceBergen and McKesson Medical-Surgical—as well as smaller companies in the industry. The organization works with pharmaceutical companies where its members have money invested.

“We are in the middle of huge successes in changing corporate behavior,” claims Meredith Miller, chief corporate governance officer of the UAW Retiree Medical Benefits Trust. “Having investor interest in changing corporate behavior will go a long way to persuading companies to address the opioid crisis.”

Resolutions have been filed with various companies asking for reporting, transparency and corporate responsibility, and votes are expected this spring.

The U.S. Food and Drug Administration on February 26 issued new guidelines for curbing the over-prescription of opioids. Scott Gottlieb, the agency commissioner at the time, expanded the FDA’s role in fighting the growing addiction to some forms of opioids such as fentanyl.

“It takes a concerted interactive effort from many agencies to combat the opioid problem,” says Donna Meyer, director of shareholder advocacy at Mercy Investment Services, the St. Louis-based investment arm for the Sisters of Mercy of the Americas endowment, an IOA member. “We want proper governance and oversight at the pharmaceutical companies. Pharmaceutical companies should not forget the public is concerned about the opioid crisis and that it poses risks to shareholders.”

The drug companies are leaving themselves open to lawsuits and settlements similar to those the tobacco industry faced, says Miller from the UAW trust, and any settlements come out of shareholders’ pockets.