A pill preparation device is disclosed. The pill preparation device includes a base, an anvil supported by the base, and a platen coupled to the base and movable relative to the anvil. The platen has a crushing surface oriented toward the anvil and a rolling surface on a side opposite the crushing surface. The pill preparation device also includes a lever arm slidably coupled to the base and rotatable about a pivot, and a roller coupled to the lever arm and offset from the pivot, such that the lever arm is operable to selectively position the roller about the platen. Force applied to the lever arm forces the platen toward the anvil to facilitate breaking up a pill disposed between the crushing surface and the anvil. Movement of the lever arm causes movement of the roller to facilitate breaking up a pill disposed between the roller and the rolling surface.