This seems a little on-the-nose, but is it
a needle? (i.e., a syringe)
Fine, precise,
needles are marked for measurement, usually fine measurement
a powerful vice.
they can contain powerful drugs, the use of which is known as a "vice"
I draw up blood, thin crimson penned;
well, drawing up blood is one thing that needles are known to do
Yet with never a wound can I contend.
a needle will ... probably? ... not release as much blood as an open wound would
Under careful conditions am I used,
doctors and nurses try to be careful when using needles
although on occasion I've been abused.
as mentioned above, needles can be used to inject drugs. in some cases this is called "drug abuse"
Many an ache have I helped ease;
opioid narcotics (the legal kind and the illegal kind), for one example, are administered with needles
I have even aided the diseased.
as noted above, needles can be used to inject substances for medicinal purposes
I have helped many people escape;
"escape" is being used in the mental/emotional sense here - drugs administered with needles can provide an escape from reality
yet I imbue no movement.
the needle itself does not propel anyone forward (or in any other direction), per se
I really feel like I'm missing something about this one