Not too sure about North America, but Ndrangheta's stakes in the European cocaine market are enormous. I'm willing to bet other major cocaine trafficking groups in the EU right now - British, Irish, Dutch, North Africans, Albanians, Serbs, Turks or even Antilleans - sooner or later get to deal with them.
They have a terrifying reputation. I don't know when, why or even how they got this reputation, but just a mere mention of their presence in some circles is enough to create a climate of fear.