The state's largest health insurer has cut prescriptions of narcotic painkillers by an estimated 6.6 million pills in 18 months as part of a campaign to curb abuse of the powerful drugs, according to executives from Blue Cross Blue Shield of Massachusetts. That estimated reduction appears to bolster the argument made by many health workers that these narcotics have been overprescribed and too easy to obtain. The drugs are cited as a gateway to heroin, which has plagued the state recently amid a startling succession of overdoses and deaths.