These groups seem to find themselves between a street gang and a drug cartel. They're definitely a form of (major) organized crime and they move tons and tons of dope. A lot of drug money is invested in real estate in the country of origin and some of the gang bosses seem to own a lot of property in their respective countries.

On an international level the strongest and best connected Caribbean groups seem to be in Jamaica, Dominican Republic, Haiti and Puerto Rico. Most of those have operations in North America and in the case of Jamaica in the UK as well (even though their presence has declined a bit over there).

Another Caribbean country whose pull in the drug trade isn't to be underestimated is Curaçao. It's a small country, but due to their connection with the Netherlands there are plenty of Curaçaoan gangs that move a lot of drugs through the Netherlands into Europe. Curaçaoan criminals based in the Netherlands are getting increasingly organized, far beyond the "petty street thing" they used to be known for in the 80's. They definitely got the connections these days, they definitely got the muscle and they're ruthless enough to hold their own.