The Council on Foreign Relations (CFR) has released a report detailing the public health implications, economic impact and national security risks presented by the U.S. opioid epidemic. According to the New York City–based think tank, in addition to contributing to high rates of hepatitis C virus (HCV), HIV and overdose deaths across the country, the crisis imperils a number of non-health-related outcomes—and is likely threatening America’s standing as a global power.

The comprehensive overview, published as part of CFR’s “Backgrounder” series, explains how drugs like prescription painkillers, heroin and fentanyl have contributed to the current scale of the epidemic (33,000 overdose deaths in 2015). The report also investigates the demographics and socioeconomic consequences of addiction, as well as its toll on America’s health care, foster care and workforce infrastructures.

CFR ends the overview by comparing the U.S. response to its opioid epidemic to that of several other countries to their own drug crises. These include the Netherlands, Canada and Australia, which are currently considered to be at the global forefront of harm reduction and addiction-fighting efforts. For instance, in the Netherlands, public health officials permit the sale and use of small amounts of cannabis to steer users away from so-called hard drugs and also began offering heroin at no cost to those suffering from addiction as long ago as the 1990s to cut down on organized crime. In Canada, supervised injection facilities are helping injection drug users consume drugs in a controlled environment, while Australia recently launched a nationwide electronic system to monitor opioid prescriptions across the country. 

Whether the current U.S. administration will heed the warnings of the CFR report remains unknown. However, with overdose deaths more than quadrupling across the country since 1999, declining labor-force participation among young, mostly white Americans and continuing infiltration of drugs into the U.S. despite billions in border patrol funding (most come via U.S. ports), it’s clear the country needs to take additional steps to rein in the crisis.