“You cannot hold an organization accountable if they are paying your bills,” said Lexi Reed Holtum, executive director of the Steve Rummler HOPE Network, which advocates on addiction issues in Minnesota. Ms. Holtum said she respected Ms. Nickel’s intentions but worried about the risks of teaming up with an industry with a self-serving agenda.

The partnership with Ms. Nickel also sheds light on the industry’s efforts to shape the perception of its role in the nation’s opioid epidemic, which President Trump has called a “national health emergency.” By enlisting a prominent advocate as a partner, PhRMA is trying to position the industry on the right side of a health crisis that many blame it for creating.

The drug industry is a formidable force in state and federal politics, investing hundreds of millions of dollars a year in lobbyists, campaign donations and public relations campaigns. In 2017, PhRMA spent close to $26 million on lobbying at the federal level, hiring 169 federal lobbyists to work on its behalf, according to the Center for Responsive Politics.

Its donation to the Addiction Policy Forum was the centerpiece of what PhRMA described in December as a “major commitment” to addressing the opioid crisis. It unveiled a set of policy proposals that include supporting seven-day limits on opioid prescriptions for acute pain, and announced a partnership with the federal government on initiatives to battle addiction.

“We feel very strongly about trying to do our part,” Mr. Ubl said.

At the same time, drugmakers are fighting to protect their profits in the face of measures such as the proposed tax in Minnesota. Gross sales of narcotic painkillers totaled $8.6 billion in 2016, according to IQVIA, a health care analytics company.

Activists and lawmakers, however, are stepping up their pressure on the industry. Last month, Gov. Andrew M. Cuomo proposed a similar tax in New York. At least six other states have considered an opioid tax over the past year, according to the National Conference of State Legislatures. Dozens of cities and counties have sued opioid manufacturers and distributors, mirroring the legal strategy that extracted billions from the tobacco companies to offset health-associated costs from smoking.