John Dagle has seen the impact of opioids from all sides. His wife's niece died of an overdose a year ago. His fellow Teamsters get injured on the job and are given pills for pain - a dozen or so in his local alone.

"They get prescribed these meds, and that's the last we see of them," said Dagle, president of Local 628 in Philadelphia.

On Thursday, he was seeing — or protesting — a company's role in America's opioid epidemic.

About 40 Teamsters rallied outside the Sofitel Hotel Philadelphia while pharmaceutical wholesaling giant AmerisourceBergen Corp. held a shareholders meeting inside.

The company, based in Chesterbrook, is one of three that distribute most of the pharmaceuticals in the United States. The Teamsters' pension and benefit funds own shares in the company, and union officials were inside the meeting demanding that the board investigate practices by company sales representatives and include compliance in the metric used to award executive compensation.

"AmerisourceBergen! America's Hurtin'!" the Teamsters chanted outside.

Inside, the company agreed to a future meeting to discuss the issues.

Attempts to slow the epidemic of addiction by pursuing civil or criminal actions against pharmaceutical companies have mainly targeted manufacturers such as Purdue Pharma (maker of OxyContin),  Insys Therapeutics (Subsys sublingual fentanyl spray), and Teva Pharmaceuticals (fentanyl lollipop Actiq), the Israeli giant with U.S. headquarters in North Wales, Montgomery County.

But the distributors — dominated by little-known yet huge companies such as McKesson Corp. (No. 5 on the Fortune 500 list), AmerisourceBergen (12), and Cardinal Health (21) — are starting to get more attention as investigations have found startling statistics such as this one: Nearly nine million hydrocodone pills were shipped over two years to a single pharmacy in a West Virginia town with 392 residents. AmerisourceBergen recently settled a lawsuit with the state even as a group of small towns and counties filed their own.

As it happens, Teamsters general secretary-treasurer Ken Hall is from West Virginia, which has by far the highest overdose fatality rate in the nation. (Pennsylvania is No. 6, with more than 3,000 deaths in 2015.)

The Teamsters say Hall has led their ongoing push to have McKesson's board take a closer look at compliance issues and hold the CEO responsible for failures by including them in the metric for executive compensation. The union brought similar demands to AmerisourceBergen's shareholders meeting Thursday.

Hall did not attend, but he said in a statement beforehand that the board must "undertake a thorough investigation of the company's sales practices, compliance programs, and senior executives who dropped the ball."

The meeting, which was open only to shareholders, lasted less than a half-hour before an audience of fewer than three dozen. Steven Collis, company president and CEO, suggested that the two sides schedule a meeting to discuss the issues.

"We depend on pharmacies ordering products appropriately and doctors or other licensed providers prescribing them to patients appropriately, and we're interested in collaborating with those who share in our mission to provide safe access to medication," the company said in a statement distributed afterward by Gabe Weissman, vice president for communications. It said the meeting would be "to share ideas and provide accurate information on our role in the supply chain and the significant steps we take to prevent drug diversion."

Michael Pryce-Jones, a governance analyst in the Teamsters department that monitors the union's investments, said engagement with the company would be "a good step, but it is not a significant step forward."

AmerisourceBergen may be "underestimating the kind of reputational, legal, and political risks they face," Pryce-Jones said. He drew a parallel with the Wells Fargo scandal that began with reports of unethical activity by sales reps and has deeply shaken the bank, whose board cut eight executives' pay on Wednesday.

At the rally outside the meeting, Rocky Bryan Jr., president of Teamsters Local 929, was more concerned with how opioids prescribed after injuries were affecting his members. "We put them in rehabilitation," he said.  "That stuff is not something to mess with."