it's regulated as part of the illicit drug supply chain. you can own a pill press just as you can a firearm, as long as you register it and follow the rules.
All of these can be used for other purposes. A pill press is far more targeted than a car, a pair of trousers, or a gallon of water.
Also reminds how back then, when i was relatively new to the US, veterinary giving me a syringe instructed me to put it into a pocket to make sure it isn't visible. I was perplexed to say the least - hide plastic syringe from view in a country where i had heard you can walk openly on the street with semi-automatic version of Kalashnikov :)